MULTIPLE INTRAMEDULLARY SPINAL SARCOIDOSIS - CASE-REPORT

BACKGROUND According to past reported cases, spinal intramedullary sar coidosis has the radiologic characteristics of a single enhanced lesio n with cord swelling, However, it is difficult to make a diagnosis usi ng only radiologic examinations. Including our case, 20 cases have bee n reported of intramedullary spinal sarcoidosis, Only six cases were d iagnosed as primary spinal sarcoidosis. We present a rare case of mult iple spinal intramedullary sarcoidosis without cord swelling. CASE DES CRIPTION This 63 year-old man was afflicted with progressive parapares is and numbness of the lower extremities. Magnetic resonance imaging s howed intramedullary lesions without cord swelling. The patient underw ent biopsy for diagnosis and the specimen showed a noncaseating granul oma mainly composed of epitheloid cells, Postoperative corticosteroid therapy was effective and the lesion disappeared 1 month after the ope ration. CONCLUSIONS Biopsy is a less invasive method and is useful for early diagnosis. Early diagnosis is important far spinal sarcoidosis so that high-dose corticosteroid therapy can be commenced while the le sion still has a good chance of being successfully treated, (C) 1997 b y Elsevier Science Inc.