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Neurosarcoidosis Presenting as a Cerebellar Mass

  • Case Reports/Clinical Vignettes
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Abstract

CASE REPORT

A 74-year-old farmer presented with worsening headaches, gait unsteadiness, and writing difficulties. On examination, he had a tendency to fall to the right and right-sided dysmetria and dysdiadochokinesis. Magnetic resonance imaging initially showed abnormalities in the right cerebellar hemisphere, suggestive of subacute infarct or infiltrating malignancy. Suboccipital craniotomy and biopsy revealed noncaseating granulomas suggestive of sarcoidosis. He was initially treated with steroids and later switched to Infliximab. On follow-up 5 months later, symptoms and imaging had improved.

DISCUSSION

Sarcoidosis affects the central nervous system in about 5% of patients. It usually manifests with cranial nerve palsies. It may rarely mimic a tumor as in this patient. Despite the dearth of controlled studies addressing neurosarcoidosis treatment, excellent responses to corticosteroids have been documented. Infliximab has been used as a steroid-sparing agent in neurosarcoidosis. We present this case of neurosarcoidosis presenting as a cerebellar mass to increase awareness of this condition.

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Acknowledgements

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Authors and Affiliations

  1. Department of Internal Medicine, Mayo Clinic, 200 2nd Street SW, Rochester, MN, 55905, USA

    Gautam Kumar MBBS, MRCP(UK)

  2. Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA

    Caroline A. Kang MD

  3. Department of Pathology, Mayo Clinic, Rochester, MN, 55905, USA

    Caterina Giannini MD

Authors
  1. Gautam Kumar MBBS, MRCP(UK)
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  2. Caroline A. Kang MD
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  3. Caterina Giannini MD
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Corresponding author

Correspondence to Gautam Kumar MBBS, MRCP(UK).

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Kumar, G., Kang, C.A. & Giannini, C. Neurosarcoidosis Presenting as a Cerebellar Mass. J GEN INTERN MED 22, 1373–1376 (2007). https://doi.org/10.1007/s11606-007-0272-7

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  • DOI: https://doi.org/10.1007/s11606-007-0272-7

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