Neurosarcoidosis presenting as an incidental solitary crania
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Sarcoidosis is an inflammatory disease of unknown etiology that usually manifests with systemic symptoms in the lungs, skin, and eyes. Approximately, 5-16% of patients with sarcoidosis may have central nervous system (CNS) involvement, termed neurosarcoidosis. Neurosarcoidosis may present variably depending on the degree of CNS involvement, ranging from cranial nerve palsies, hydrocephalus, diabetes insipidus, and rarely myelopathy. Isolated neurosarcoidosis without prior systemic symptoms is extremely rare, occurring in approximately 2% of patients with neurosarcoidosis. Due to its rarity, mistakes in diagnosis and treatment occur commonly. We present a case of a 47-year-old female who was found to have an incidentally discovered solitary intracranial lesion that mimicked a high-grade neoplasm but was later confirmed to be neurosarcoidosis. Incidental solitary neurosarcoid granulomas are difficult to diagnose due to its nonspecific clinical and imaging presentations.

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