Spinal Cord Series and Cases, 2021 · DOI: https://doi.org/10.1038/s41394-021-00450-1 · Published: September 15, 2021
Sarcoidosis is a disease where inflammatory cells form clumps called granulomas in different parts of the body. Neurosarcoidosis is when this happens in the nervous system. This report describes a rare case where these granulomas formed outside the spinal cord and inside the cord, leading to problems with movement and sensation. The patient experienced numbness, weakness, and pain in her legs. Doctors found lesions compressing her spinal cord. After surgery and treatment with medications that suppress the immune system, the patient's condition improved. This case is unusual because the granulomas were found outside the spinal cord (extradural), which is rare. Most cases involve granulomas within the spinal cord (intradural). The patient also did not have lung involvement, which is commonly seen in sarcoidosis.
Clinicians should consider neurosarcoidosis in the differential diagnosis of patients presenting with progressive myelopathy and spinal cord compression, even in the absence of pulmonary involvement.
Management of extradural neurosarcoidosis may require a combination of surgical decompression and immunosuppressive therapy to achieve optimal outcomes.
Given the rarity of extradural neurosarcoidosis, further research is needed to better understand its pathogenesis, clinical course, and optimal treatment strategies.