Cerebral Amyloidoma: A Report of Three Cases
RK Kraus, MJ Schniederjan, SB Hunter. Emory University, Atlanta, GA
Background: Amyloidomas, or tumor-like aggregates of amyloid, are very uncommon within the central nervous system, with approximately 30 cases reported to date. The most common clinical presentations of cerebral amyloidomas are seizures, hemiparesis, gait disturbance, visual abnormalities, and cognitive impairment.
Design: A review of the Emory University electronic medical record from 1988-2008 revealed three cases of primary cerebral amyloidoma. The slides, radiology and medical records were reviewed for each case.
|45||Female||Left-sided headache, sudden onset mental status changes, status epilepticus||Right posterior parietal||Contrast enhancing mass on MRI||Migraines||Biopsy only||Amyloid, Congo red +|
|46||Female||Nausea, slurred speech, pressure on right side of head, seizures with aura||Right temporal lobe extending into anterior parietal lobe||Contrast enhancing mass on MRI||Multiple sclerosis||Excision||Amyloid, Congo red +|
|72||Female||Ataxia, slurred speech||Left pons, right basal ganglia at Foramen of Monro||Contrast enhancing mass on MRI||Coronary artery disease, Hypertension, Hypothyroidism||Biopsy only||Amyloid, Congo red +|
The mean age at presentation was 54.3 years. All cases presented as enhancing mass lesions confined to the brain. Prior to biopsy, patients 1 and 3 were felt clinically to have high-grade glioma and CNS lymphoma, respectively. Patient 2 was thought to have a demyelinating lesion. None of the patients had evidence of systemic amyloidosis. Serum protein electrophoresis performed on patient number 3 was within normal limits.
Conclusions: Cerebral amyloidomas are uncommon lesions that present with a variety of symptoms and may manifest clinically as malignant neoplasms. The second patient in our series is the third reported case of amyloidoma in association with multiple sclerosis. This may represent a rare, and as of yet unrecognized, sequela of multiple sclerosis.
Tuesday, March 10, 2009 9:30 AM
Poster Session III # 203, Tuesday Morning