title: Clinical, radiological, and biochemical features of a bilateral buttock amyloidoma emerging after 27 years of hemodialysis.
abstract: Deposition of amyloid in the buttock is a rare complication of dialysis related amyloidosis (DRA), but this localization is even rarer in other types of amyloidoses. We report here the clinical, radiological, and biochemical features of a patient who incurred into this complication after 27 years of hemodialysis. Imaging of the amyloid deposition by magnetic resonance imaging (MRI) documents the amyloid infiltration in the muscles of the buttock region and highlights a peculiar feature of amyloid fibrils deposition in the subcutaneous fat. The amyloid deposition is confirmed by biochemical and microscopic analysis of fibrils extracted from a biopsy specimen. Review of literature and the features of this case lead to speculation that the peculiar involvement of the buttock region including muscles and subcutaneous fat in DRA might derive from the propagation of amyloid initially deposited in the hip joint.
authors.affiliation: IRCCS Fondazione Salvatore Maugeri, Pavia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Montagna
authors.forename: Sara
authors.initials: S
authors.lastname: Raimondi
authors.forename: Guido
authors.initials: G
authors.lastname: Moro
authors.forename: Carla
authors.initials: C
authors.lastname: Uggetti
authors.forename: Annalisa
authors.initials: A
authors.lastname: Relini
authors.forename: Umberto
authors.initials: U
authors.lastname: Magrini
authors.forename: Gennaro
authors.initials: G
authors.lastname: Esposito
authors.forename: Sofia
authors.initials: S
authors.lastname: Giorgetti
authors.forename: Luigi
authors.initials: L
authors.lastname: Congi
authors.forename: Mario
authors.initials: M
authors.lastname: Mosconi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Galli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Villa
authors.forename: Siro
authors.initials: S
authors.lastname: Segagni
authors.forename: Simona
authors.initials: S
authors.lastname: Donadei
authors.forename: Laura
authors.initials: L
authors.lastname: Obici
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Merlini
authors.forename: Monica
authors.initials: M
authors.lastname: Stoppini
authors.forename: Vittorio
authors.initials: V
authors.lastname: Bellotti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000682:Amyloid / Q000737:chemistry / Q000378:metabolism; D000686:Amyloidosis / Q000209:etiology* / Q000378:metabolism / Q000473:pathology*; D001706:Biopsy; D002081:Buttocks / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D018625:Microscopy, Atomic Force; D008875:Middle Aged; D011859:Radiography; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: D000682:Amyloid