Sarcoidosis is a chronic, multisystem, granulomatous disease of unknown etiology. It manifests with a wide range of symptoms and clinical findings, including some that occur in the head and neck. Sinonasal sarcoidosis, in particular, frequently demonstrates a rather recalcitrant course and a potential for severe complications if left untreated. We present the case of a 46-year-old woman with extensive sinonasal sarcoidosis that progressed to involve the skull base and olfactory tract and ultimately led to the formation of a granuloma within the frontal lobe that required craniotomy and excision. Although surgery is not considered the primary treatment modality for sarcoidosis, it may have a role in managing this highly variable disease in certain patients.
IntroductionSarcoidosis is a chronic, multisystem, granulomatous disease of unknown etiology that manifests with a wide range of symptoms and clinical findings. Predominantly a disease of the pulmonary system, it can affect nearly every part of the body. Head and neck involvement is rather uncommon, occurring in 9 to 15% of patients.1 Central nervous system involvement has also been reported, although the incidence of diagnosed neurosarcoidosis is only 5%.2