Neurosarcoidosis presenting as a retroclival mass

A head magnetic resonance imaging scan on a 22-year-old black woman with a 1-year history of brain stem symptoms showed a retroclival mass. Noninvasive studies were unhelpful in characterizing the lesion. Biopsy of the mass showed noncaseating granulomas, consistant with sarcoidosis. Symptoms improved on steroid treatment. Sarcoidosis should be considered in the differential diagnosis of a retroclival mass; difficulties in the noninvasive investigation of neurosarcoidosis are discussed.