SARCOIDOSIS EN-PLAQUE - REPORT OF A CASE AND REVIEW OF THE LITERATURE

A 31-year-old black male with sarcoidosis en-plaque of the dura mater, which is a rare morphological variant of neurosarcoidosis (NS), prese nted at our clinic. Magnetic resonance imaging (MRI) of the head with gadolinium showed non-specific enhancement of both tentorial leaves ex tending to the floor of right middle cranial fossa and cavernous sinus . The laboratory results were normal except for slightly increased ser um angiotensin converting enzyme (SAGE) (68 U/ml n = 4-56 U/ml) and ce rebrospinal fluid (CSF) IgG index (0.57, n = 0.46). Biopsy of the intr acranial dural lesion was consistent with sarcoidosis. Oral steroid th erapy (Methylprednisolone 4 mg QID) was started and the patient became asymptomatic. However, MRI of the brain with gadolinium 2 months afte r biopsy showed progression and extension of the enhanced dural lesion . His SAGE level was unchanged. We concluded that progression of the e nhanced lesion seen in MRI could be recently formed scar tissue, new l esion or both. MRI findings should always be correlated with clinical findings for evaluation of NS during follow-up.