Neurosarcoidosis Presenting as a Cerebellar Mass
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Auteurs : Gautam Kumar [États-Unis] ; Caroline A. Kang [États-Unis] ; Caterina Giannini [États-Unis]Source :
- Journal of General Internal Medicine [ 0884-8734 ] ; 2007-09-01.
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Abstract
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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DOI: 10.1007/s11606-007-0272-7
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Neurosarcoidosis Presenting as a Cerebellar Mass</title><author><name sortKey="Kumar, Gautam" sort="Kumar, Gautam" uniqKey="Kumar G" first="Gautam" last="Kumar">Gautam Kumar</name><affiliation wicri:level="1"><mods:affiliation>Department of Internal Medicine, Mayo Clinic, 200 2nd Street SW, 55905, Rochester, MN, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Internal Medicine, Mayo Clinic, 200 2nd Street SW, 55905, Rochester, MN</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>E-mail: kumar.gautam@mayo.edu</mods:affiliation><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Kang, Caroline A" sort="Kang, Caroline A" uniqKey="Kang C" first="Caroline A." last="Kang">Caroline A. Kang</name><affiliation wicri:level="1"><mods:affiliation>Department of Neurology, Mayo Clinic, 55905, Rochester, MN, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, Mayo Clinic, 55905, Rochester, MN</wicri:regionArea></affiliation></author><author><name sortKey="Giannini, Caterina" sort="Giannini, Caterina" uniqKey="Giannini C" first="Caterina" last="Giannini">Caterina Giannini</name><affiliation wicri:level="1"><mods:affiliation>Department of Pathology, Mayo Clinic, 55905, Rochester, MN, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology, Mayo Clinic, 55905, Rochester, MN</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:A0AD04130DE322191A05F25CE8BB58621AD41463</idno><date when="2007" year="2007">2007</date><idno type="doi">10.1007/s11606-007-0272-7</idno><idno type="url">https://api.istex.fr/ark:/67375/VQC-NV7CG1Q0-5/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">000123</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000123</idno><idno type="wicri:Area/Istex/Curation">000123</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Neurosarcoidosis Presenting as a Cerebellar Mass</title><author><name sortKey="Kumar, Gautam" sort="Kumar, Gautam" uniqKey="Kumar G" first="Gautam" last="Kumar">Gautam Kumar</name><affiliation wicri:level="1"><mods:affiliation>Department of Internal Medicine, Mayo Clinic, 200 2nd Street SW, 55905, Rochester, MN, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Internal Medicine, Mayo Clinic, 200 2nd Street SW, 55905, Rochester, MN</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>E-mail: kumar.gautam@mayo.edu</mods:affiliation><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Kang, Caroline A" sort="Kang, Caroline A" uniqKey="Kang C" first="Caroline A." last="Kang">Caroline A. Kang</name><affiliation wicri:level="1"><mods:affiliation>Department of Neurology, Mayo Clinic, 55905, Rochester, MN, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, Mayo Clinic, 55905, Rochester, MN</wicri:regionArea></affiliation></author><author><name sortKey="Giannini, Caterina" sort="Giannini, Caterina" uniqKey="Giannini C" first="Caterina" last="Giannini">Caterina Giannini</name><affiliation wicri:level="1"><mods:affiliation>Department of Pathology, Mayo Clinic, 55905, Rochester, MN, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology, Mayo Clinic, 55905, Rochester, MN</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of General Internal Medicine</title><title level="j" type="abbrev">J GEN INTERN MED</title><idno type="ISSN">0884-8734</idno><idno type="eISSN">1525-1497</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>New York</pubPlace><date type="published" when="2007-09-01">2007-09-01</date><biblScope unit="volume">22</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1373">1373</biblScope><biblScope unit="page" to="1376">1376</biblScope></imprint><idno type="ISSN">0884-8734</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0884-8734</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Infliximab</term><term>cerebellar mass</term><term>neurosarcoidosis</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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