An Imitation Too Perfect: Isolated Neurosarcoidosis Mimicking Spheno-Orbital Meningioma With Hyperostosis

We report a rare case of isolated neurosarcoidosis presenting as a spheno-orbital mass with hyperostosis of the sphenoid wing, initially misdiagnosed as a meningioma. Neurosarcoidosis may manifest as dural-based lesions that mimic tumors radiologically; however, hyperostosis, a hallmark of meningiomas, is usually absent. This unusual presentation causes diagnostic confusion. This case highlights the diagnostic challenges when sarcoidosis mimics meningiomas, particularly in the presence of hyperostosis. Awareness of such atypical presentations is crucial for accurate diagnosis and appropriate management.