Spinal cord sarcoidosis presenting as an intramedullary mass: a case report

A case of spinal cord sarcoidosis mimicking an intramedullary tumor is reported because of its rarity and difficulty in diagnosis before surgery. A 66-year-old woman began to suffer from chronic thoracic myelopathy in August, 1996. She had a history of intrathoracic sarcoidosis with left hilar adenopathy in 1991, which disappeared completely after steroid therapy for one month. Magnetic resonance imaging of the T-spine performed on 4 June, 1997, showed normal appearance in T1-weighted and T2-weighted images but abnormal enhancement at the T10-11 level. Open biopsy revealed noncaseating granulomatous inflammation and perivascular lymphocytic infiltration. Following biopsy, methylprednisolone 750 mg was given daily for three days followed by prednisolone 60 mg per day. The patient was discharged on 10 July, 1997, in a stable condition. She died on 22 July, 1997, at a local hospital due to urinary tract infection with sepsis.