Journal of Neuro-Oncology

, Volume 91, Issue 1, pp 113–116

Sarcoidosis of the pineal gland: an unusual presentation of neurosarcoidosis

  • Isaac Yang
  • Amy Delpolyi
  • Michael E. Sughrue
  • James Rubenstein
  • Andrew W. Bollen
  • Andrew T. Parsa
Case Report

DOI: 10.1007/s11060-008-9687-1

Cite this article as:
Yang, I., Delpolyi, A., Sughrue, M.E. et al. J Neurooncol (2009) 91: 113. doi:10.1007/s11060-008-9687-1

Abstract

Introduction Sarcoidosis is an inflammatory disease characterized by noncaseating granulomas that is rarely found as primary CNS pathology. We report an unusual case of sarcoidosis involving the pineal gland with radiographic, histopathology, and clinical data. Case report A 45-year-old man without evidence of systemic sarcoidosis presented with a history of gradual onset of blurry vision and diplopia that progressed over 3 months. MR imaging demonstrated an enhancing mass in the pineal region. A suboccipital craniotomy was performed with resection of the mass through a supra-cerebellar infratentorial approach. Histopathologic analysis did not reveal a pineoblastoma but instead revealed noncaseating granulomas within the pineal gland. Extensive hematologic laboratory examinations, cerebral spinal fluid studies, and cultures for infection were all negative. This mass lesion was diagnosed as solitary neurosarcoidosis of the pineal gland, without dissemination. The patient was treated with steroids and at 4-year follow-up is asymptomatic with an unremarkable MRI scan. Conclusion This is an unusual case of pineal sarcoidosis mimicking a tumor with associated MRI, CT and histopathologic findings reported together. Although rare, sarcoidosis of the pineal gland should not be excluded from a comprehensive differential diagnosis of an enhancing pineal region mass.

Keywords

Pineal glandSarcoidGranulomatousInflammationPineoblastoma

Copyright information

© Springer Science+Business Media, LLC. 2008

Authors and Affiliations

  • Isaac Yang
    • 1
  • Amy Delpolyi
    • 1
  • Michael E. Sughrue
    • 1
  • James Rubenstein
    • 2
  • Andrew W. Bollen
    • 2
  • Andrew T. Parsa
    • 1
  1. 1.Department of Neurological Surgery and Brain Tumor Research CenterUniversity of California, San Francisco, UCSF School of MedicineSan FranciscoUSA
  2. 2.Department of Hematology and OncologyUniversity of California, San Francisco, UCSF School of MedicineSan FranciscoUSA