Manifestation of Isolated Vertebral Osseous Sarcoidosis: A Case Report.

INTRODUCTION: Isolated vertebral osseous sarcoidosis is a rare form of sarcoidosis that may mimic malignancy or infection and can be difficult to diagnose in the absence of systemic symptoms. CASE PRESENTATION: A 70-year-old African American woman presented with lower back pain, 5 years after an initial evaluation of incidental vertebral lesions identified on positron emission tomography imaging. Repeat imaging showed a lesion in the T4 vertebra. Computed tomography-guided biopsy and thorough evaluation excluded infection and malignancy, confirming vertebral sarcoidosis. DISCUSSION: Few cases of vertebral sarcoidosis have been reported, usually presenting with localized pain and lytic or sclerotic vertebral lesions. Diagnosis requires histopathologic confirmation and exclusion of alternative etiologies. Early recognition is important, as corticosteroid treatment often improves outcomes. CONCLUSIONS: Sarcoidosis should be considered in the differential diagnoses of vertebral lesions, even in the absence of systemic involvement.