Imaging of Focal Amyloid Depositions in the Head, Neck, and Spine: Amyloidoma

H Parmar,T Rath,M Castillo,D Gandhi

doi:10.3174/ajnr.a1977

Abstract

Amyloidomas are benign tumorlike lesions consisting of localized deposits of amyloid and are the rarest form in the group of amyloidosis-related lesions. Diagnosis requires special stains; therefore, a high degree of suspicion for this disease is required. In this review, we describe the imaging features of amyloidomas involving the intracranial compartment, head and neck, and spine. We also discuss the differential diagnosis and briefly review the pertinent literature.

Highlights

Solitary or focal amyloidoma not associated with multiple myeloma is a rare entity with only a few cases or series reported in the literature.[2,3,4,5,6,7,8,9,10,11,12,13,14,15]
We found 30 cases of intracranial amyloidoma,[6,7,8 20] cases involving the gasserian ganglion,[9,16 6] cases of skull base amyloidoma,[4,5] and 29 cases of amyloidoma involving the spine (8 cervical, 17 thoracic, 2 lumbar, and 2 sacral).[2,3,12,13]
Amyloidomas are slow-growing benign lesions that generally have a favorable prognosis as opposed to systemic amyloidosis

Summary

Introduction

Solitary or focal amyloidoma not associated with multiple myeloma is a rare entity with only a few cases or series reported in the literature.[2,3,4,5,6,7,8,9,10,11,12,13,14,15] There is a marked preference for skull and spinal involvement. Fine irregular radiating lines at the edge of the tumor have been described in some published cases (Fig 1D).[8] These lines may indicate deposition of amyloid along the blood vessels, probably small-sized arteries, a finding that has been observed in pathology specimens (Fig 1E).[28] Primary amyloidomas, though rare, should be included in the differential diagnosis of intra-axial masses that show little or no mass effect, are hyperattenuated on nonenhanced CT and hyperintense on T1WI, and show avid homogeneous enhancement with contrast.

Results

Conclusion