Diagnostic dilemmas Neurosarcoidosis masquerading asglioma ofthe optic chiasm inachild

Summary We presenta caseofsarcoidosis ina 14-year-old girlwho presented witha shorthistory ofvisual disturbance. Computedtomography andmagnetic resonance imaging(MRI) demonstrated enlargement oftheoptic chiasmandprechiasmic optic nerves. Post-contrast MRI showedmarginalenhancement ofthe affected areasoftheopticpathways. A diagnosis of opticnervegliomaand arachnoid gliomatosis wasmade;surgical confirmation wasnotsoughtduetothe risktovision associated withbiopsy. A rapidclinical deterioration ledtorepeat MRI which demonstratedextensive enhancingsofttissuethroughout the basalcisterns withextension intothe brain. Biopsyconfirmed a diagnosis of sarcoidosis.