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Images in Neurology
January 2005

Neurosarcoidosis Mimicking Meningioma

Arch Neurol. 2005;62(1):148-149. doi:10.1001/archneur.62.1.148

A 45-year-old African American woman presented with a several-month history of hearing loss, left ear pain, and sensory loss on the left side of the face. Three years previously, she had developed a left corneal abrasion that incompletely healed and resulted in persistent blurred vision. Neurologic examination at the time of presentation revealed clouding of the left cornea and complete left trigeminal sensory and motor deficits. A computed tomographic image of the head with contrast showed a large intracranial mass involving the left middle cranial fossa, cavernous sinus, Meckel cave, cerebellopontine angle, and left internal auditory canal. A magnetic resonance image of the brain revealed a large mass that was isointense to the brain parenchyma on T1-weighted images and hypointense on T2-weighted images (Figure, A). After gadolinium administration (Figure, B), the mass demonstrated homogeneous enhancement. The main differential diagnosis was left petroclival meningioma involving the left cavernous sinus and Meckel cave.

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