SPHENO-CAVERNOUS MENINGEAL NEUROSARCOIDOSIS - REPORT OF ONE CASE AND REVIEW OF LITERATURE

The authors report on the case of a 32 years old woman treated with pr ednison and diphenylsulfon for a multivisceral sarcoidosis ; headache and progressive oculomotor paralysis revealed an expansive lesion of t he left cavernous sinus extending to the temporal fossa. C.T. scan, M. R.I., and angiographic data as well as the intra-operative findings ev oked the diagnosis of meningioma. Pathological findings showed an epit helioid and gigantocellular granuloma without caseous necrosis, corres ponding to a sarcoidosic lesion. After the operation, the increase of steroid doses was followed by a complete regression of the tumoral rem nants, and total clinical recovery. In a patient having a previously d iagnosed sarcoidosis with evidence of an intracranial tumor mimicking a meningioma, steroids should be first prescribed. Efficacy of steroid s on sarcoid granulomas is often dramatic; surgical approach would be discussed in case of ineffective steroid therapy, of persisting questi onnable diagnosis, and of tumoral threatening compression.