Nguyen Hien, Le Connie, Nguyen Hanh
Department of Internal Medicine, Kaiser Permanente-Mid Atlantic, Camp Springs Medical Center, Temple Hills, MD 20748, USA.
South Med J. 2010 Sep;103(9):940-2. doi: 10.1097/SMJ.0b013e3181e90745.
This is a case which highlights unique diagnostic challenges in the evaluation of a previously healthy patient presenting with a myelopathy initially most concerning for malignancy. However, timely recognition and nonoperative therapy of unexpected spinal sarcoidosis with corticosteroidal therapy was crucial in averting the sequelae of undiagnosed or misdiagnosed neurosarcoidosis, which can be devastating and life-threatening. Diagnosis is challenging due to significant similarities in clinical and roentgenographic findings of spinal sarcoidosis with infection, inflammation, and malignancy. Our case demonstrates that diagnosis of spinal sarcoidosis is especially elusive when it is the initial manifestation of sarcoidosis.
