Case report: middle-aged woman from Ghana with unsteady gait and enlarging cerebellar mass.

RATIONALE

Neurosarcoidosis (NS) is an uncommon manifestation of systemic sarcoidosis, with a propensity for middle-agedwomen. Often discovered only at autopsy, rates of neurologic involvement (5%-10%) reported in the literature underscore a lack of sensitivity and specificity in current diagnostic methods.

PATIENT CONCERNS

Herein, we describe a 53-year-old woman who presented with gait imbalance and distal extremity muscular weakness. She was known to harbor a brain mass (4 years in duration) that was monitored and recently seemed to enlarge.

DIAGNOSIS

A subsequent brain biopsy showed necrotizing granulomatous inflammation suggestive of NS. However, no clinical or radiologic evidence of activity was found in other organs.

INTERVENTIONS AND OUTCOMES

Ultimately, endo and transbronchial biopsies were performed, providing histologic confirmation of systemic sarcoidosis.

LESSONS

This approach is advised in all instances of suspected NS where systemic involvement is in question.