Brain amyloidoma with cerebral hemorrhage.
Unlike systemic amyloidosis, the diagnosis of brain amyloidoma without systemic manifestations is clinically challenging. Despite the availability of advanced brain imaging technology, such conditions are difficult to ascertain without brain biopsy or autopsy. We report the case of a 64-year-old woman who presented with frontal lobe syndrome with abnormal linear enhancement on brain magnetic resonance imaging. Results from a stereotactic biopsy revealed lambda-positive protein deposition in the brain parenchyma. During the course of illness, the patient had an acute cerebral hemorrhage, which manifested with hemiparesis, dysarthria, and pathologic crying. Review of the literature revealed 15 cases of primary brain amyloidoma. Patients had similar protein deposits but in different regions of the brain and therefore presented with various neurologic symptoms.
Labro
Henrick
H
Department of Medicine and Neurological Institute at St John West Shore Hospital, University Hospitals Case Medical Center in Cleveland, Ohio 44145, USA. henrick.labro@csauh.com
Al-Kadhimi
Zaid
Z
Djmil
Mounir
M
Oghlakian
Roger
R
Alshekhlee
Amer
A
D000686:Amyloidosis / Q000175:diagnosis* / Q000473:pathology; D000927:Anticonvulsants / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D013792:Thalidomide / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use
D000927:Anticonvulsants; D018906:Antineoplastic Agents, Alkylating; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D013792:Thalidomide; D014635:Valproic Acid; D003907:Dexamethasone; D008558:Melphalan