"Navigating Diagnostic Pitfalls In Isolated Neurosarcoidosis: A Case Of Simulated Meningioma".

Background: Sarcoidosis, a systemic inflammatory condition, can involve the central nervous system (CNS) in approximately 10% of cases, with isolated neurosarcoidosis occurring in 10-20%. Case Presentation: We present a case of a 55-year-old female with three months of headaches and swaying episodes. Imaging revealed a left-sided hypodense lesion, confirmed by MRI as a thickening of the dura and pachymeninges. Biopsy led to an unexpected diagnosis of non-necrotizing granulomatous inflammation consistent with sarcoidosis. Discussion: This case illustrates the diagnostic challenges of neurosarcoidosis, which can mimic other conditions like meningioma. Accurate diagnosis requires a multidisciplinary approach, especially due to the nonspecific nature of clinical and imaging findings. Conclusion: Neurosarcoidosis should be a key differential diagnosis for ambiguous CNS lesions, emphasizing the need for tissue sampling and awareness of its varied presentations.