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

## TL;DR

A rare case of neurosarcoidosis was mistaken for a meningioma due to its unusual presentation with hyperostosis.

## Contribution

This case highlights the diagnostic challenges when neurosarcoidosis mimics meningiomas with hyperostosis.

## Key findings

- Neurosarcoidosis can present as a spheno-orbital mass with hyperostosis, resembling meningiomas.
- Hyperostosis is typically absent in neurosarcoidosis but was present in this case, causing misdiagnosis.
- Awareness of atypical presentations is essential for accurate diagnosis and management.

## Abstract

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.