Sarcoidosis presenting as an intra- or extra-axial cranial mass: report of two cases

Neuroradiology. 1997 Jul;39(7):516-9. doi: 10.1007/s002340050457.


Sarcoidosis may also present as an extra- or intra-axial mass involving the central nervous system. These lesions are sometimes operated upon, because a neoplasm is suspected. We report two cases of unusual tumour-like extra- and intra-axial sarcoidosis. The extra-axial mass was just medial to the jugular foramen. Its morphology and signal characteristics differed from the more common lesions in this area. The intra-axial mass was in the temporal lobe, with only minor leptomeningeal involvement. Extra-axial sarcoidosis can be confused with a meningioma because these lesions can give relatively low signal on T2-weighted images. Intra-axial masses are presumed to represent a propagation and fusion of multiple leptomeningeal granulomas through the Virchow-Robin spaces in the brain; this pattern can be sought on contrast-enhanced T1-weighted images.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Brain / pathology
  • Brain Diseases / diagnosis*
  • Diagnosis, Differential
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Neurologic Examination
  • Sarcoidosis / diagnosis*
  • Sarcoidosis, Pulmonary / diagnosis
  • Temporal Lobe / pathology