Kim Dong Ha, Cho Won Ho, Cho Kyu Sup, Cha Seong Heon
Department of Neurosurgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Department of Otolaryngology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
J Korean Neurosurg Soc. 2014 Jan;55(1):61-3. doi: 10.3340/jkns.2014.55.1.61. Epub 2014 Jan 31.
A differential diagnosis between neurosarcoidosis and neurosyphilis is particularly problematic in patients with a positive serologic result for syphilis. We report here a patient with a solitary cavernous sinus sarcoidosis who had a history of syphilis and showed rapidly progressing cavernous sinus syndrome. A transsphenoidal biopsy was performed and a histopathologic examination revealed a non-caseating granuloma with an asteroid body. His facial pain disappeared after steroid therapy. He received oral prednisolone for one year. A follow-up magnetic resonance imaging of the brain revealed resolution of the mass over the cavernous sinus. Particularly in patients with a history of syphilis, neurosyphilis should be included in a differential diagnosis of neurosarcoidosis.
对于梅毒血清学检测呈阳性的患者，神经结节病与神经梅毒的鉴别诊断尤为困难。我们在此报告一例孤立性海绵窦结节病患者，该患者有梅毒病史，表现为快速进展的海绵窦综合征。进行了经蝶窦活检，组织病理学检查显示为伴有星状体的非干酪样肉芽肿。类固醇治疗后其面部疼痛消失。他接受了一年的口服泼尼松龙治疗。脑部的随访磁共振成像显示海绵窦区肿块消退。特别是对于有梅毒病史的患者，神经梅毒应纳入神经结节病的鉴别诊断中。
