Intradural-extramedullary isolated compressive sarcoid lesion

BACKGROUND: Sarcoid involvement of the central nervous system is a rare occurrence, with involvement in approximately 5–10% of all cases. Isolated spinal involvement is an even rarer encounter, only 0.3–1% of all cases. These lesions can form compressive nodules leading to myelopathy. In the presented case of cervical sarcoid, the patient required a decompressive procedure to address cord compression. CASE DESCRIPTION: This is the case of a 39-year-old male presenting with cervical myelopathy caused by a compressive sarcoid nodule who underwent a successful posterior decompressive procedure. The pathology demonstrated a non-caseating granuloma, consistent with sarcoid. Postoperatively, the patient's myelopathic symptoms improved. CONCLUSIONS: Sarcoid is rarely associated with an isolated compressive cervical lesion. Although sarcoid management typically involves immune suppression, in cases of active cord compression surgical intervention is warranted.