Neuroendocrine Sarcoidosis: A Rare Bird

Sarcoidosis is a systemic auto-inflammatory disease of unknown etiology. It is characterized by granuloma formation and can affect any organ. While it commonly affects the lungs and the lymphatic system, it can also involve the central nervous system, leading to neurosarcoidosis or the endocrine system and subsequent multiple endocrinal pathologies. Neurosarcoidosis can affect any part of the nervous system and therefore manifests with variable symptoms mimicking other neurological pathologies. Any endocrine gland can be infiltrated by sarcoidosis; however, the pituitary gland and the hypothalamus are the most frequently infiltrated, while thyroid sarcoidosis cases remain rare. Only a biopsy of a suspected lesion is considered to be a definitive diagnostic method, which makes diagnosing central nervous system sarcoidosis particularly challenging. This case report highlights the challenges of diagnosing neuroendocrine sarcoidosis as the first presentation.