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Case Reports
. 2023 Jun 23;15(6):e40865.
doi: 10.7759/cureus.40865. eCollection 2023 Jun.

A Perplexing Case of Bladder Mass Biopsy-Proven Neurosarcoidosis

Zainab Hanif  1 , Keysha N Gonzalez Ramos  1 , Pouyan Razminia  1 , Eboselum Aigbe  1 , Pegah Ghafourian  1
Affiliations
Case Reports

A Perplexing Case of Bladder Mass Biopsy-Proven Neurosarcoidosis

Zainab Hanif et al. Cureus. .

Abstract

Sarcoidosis is a multi-organ systemic disease that presents with several clinical manifestations, and patients can develop neurologic complications. Neurosarcoidosis may be life-threatening; therefore, early recognition and treatment are key. Here, we present a case of a 55-year-old African American male who presented with a complaint of dizziness and left-sided weakness; he ultimately received a diagnosis of neurosarcoidosis after elaborate radiographic investigations and bladder mass biopsy. Neurosarcoidosis remains a diagnostic dilemma as it can clinically and radiographically mimic multiple conditions including multiple sclerosis, central nervous system lymphoma, multiple myeloma, and progressive multifocal leukoencephalopathy.

Keywords: bladder mass; mimicking; neoplasm; neurosarcoidosis; nodular leptomeningeal enhancement.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. CT scan of the brain (axial view), on arrival, demonstrating large areas of white matter hypodensities in the bifrontal lobes as well as small areas of cortical hypodensities in the right anteroinferior frontal lobe (arrows)
Figure 2
Figure 2. Axial T1-weighted MRI of the brain with contrast showing extensive enhancing dural nodularity along bilateral frontal convexities and anterior falx (red arrow)
Figure 3
Figure 3. Axial T1-weighted MRI of the brain with contrast revealing extensive nodular leptomeningeal enhancement along the bilateral frontal lobes, suprasellar cistern, right Sylvian fissure, and right basal ganglia with associated extensive vasogenic edema extending to the lateral ventricles (red arrows)
Figure 4
Figure 4. Axial view of chest CT without contrast showing calcified right hilar adenopathy (arrow)
Figure 5
Figure 5. Pathology of the bladder mass showing noncaseating granulomas (arrow)
Figure 6
Figure 6. Pathology of the bladder mass showing noncaseating granulomas (arrow)
Figure 7
Figure 7. Diagnostic algorithm
CNS: central nervous system; CSF: cerebrospinal fluid
See this image and copyright information in PMC

References

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