Intramedullary Sarcoidosis of Cervical Spinal Cord Suspected as Intramedullary Tumor: A case report

ABSTRACT

Sarcoidosis is an idiopathic multisystem disorder that usually develops in the respiratory system, but rarely in spinal cord. A 54-year-old female patient was presented with progressive right side weakness and paresthesia below C4 level dermatome which began 3 months ago. Cervical MRI findings showed T2 weighted high signal nodular lesion with surrounding edema at the C4 and C5 vertebra level, suggestive of intramedullary spinal cord tumor. She went through the resection of the part of the mass. The result of biopsy revelaed chronic granulomatous inflammation without caseous necrosis. Despite of tuberculosis medication and proper rehabilitation program for 2 weeks, there was no improvement of symptoms with exacerbated findings on cervical MRI and increased serum angiotensin converting enzyme level. We concerned about the cervical intramedullary sarcoidosis at this point, we treated her with steroid. After 3 months, her MRI findings were improved without improvement in her symptoms.