Impact of 18F-fluorodeoxyglucose (18F-FDG) imaging in sarcoidosis: unsuspected neurosarcoidosis discovered by 18F-FDG PET and early metabolic response to corticosteroid therapy

A 46-year-old woman, with biopsy proven pulmonary sarcoidosis, was referred for an 18F-FDG PET/CT scan that depicted multivisceral involvement and an unusual 18F-FDG focus located in the pituitary fossa consistent with pituitary sarcoidosis. This was confirmed by decreased antidiuretic hormone blood levels and contrast-enhanced CT scan. This unsuspected neurosarcoidosis prompted corticosteroid therapy. A 18F-FDG-PET/CT examination performed 10 weeks after initiation of treatment revealed complete recovery. It is suggested that the skull base should be included in the PET scanning of patients with sarcoidosis. 18F-FDG imaging may be useful in the early evaluation of response to treatment.