title: Hemodialysis-related upper cervical extradural amyloidoma presenting with intractable radiculopathy.
abstract: BACKGROUND
  Destructive spondyloarthropathy may occur in long-term hemodialysis patients, but focal amyloid deposits in the spine are rare. We present a case of upper cervical extradural amyloidoma with a history of long-term hemodialysis presenting with progressive and intractable radiculopathy.
  
  
  METHODS
  We describe a 51-year-old female with a long-term history of hemodialysis treatment. She suffered progressive and intolerable right occipital headache. Neurological examination revealed right C2 radiculopathy. Magnetic resonance imaging (MRI) of the cervical spine showed a solid focal extradural mass lesion at the C2 level. She underwent subtotal resection of the extradural mass lesion and decompression of the right C2 nerve root by a posterior approach. Histological examination revealed amyloid deposits. The occipital headache immediately disappeared after surgery. Follow-up MRI 10 months after surgery demonstrated no recurrence of the extradural amyloidoma.
  
  
  CONCLUSIONS
  Development of an upper cervical extradural amyloidoma after long-term hemodialysis is extremely rare. Prompt evaluation of long-term hemodialysis patients suffering from progressive cervical pain should be recommended, and treatment is required if there are signs or symptoms of compression of a nerve root or the spinal cord.
authors: Department of Neurosurgery, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan. takeshim@naramed-u.ac.jp
authors: Yasuhiro
authors: Y
authors: Takeshima
authors: Masashi
authors: M
authors: Kotsugi
authors: Young-Su
authors: YS
authors: Park
authors: Hiroyuki
authors: H
authors: Nakase
mesh_terms: D000686:Amyloidosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D002574:Cervical Vertebrae / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D058225:Plaque, Amyloid / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D011843:Radiculopathy / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000628:therapy; D016896:Treatment Outcome