摘要
<strong>Introduction: </strong>Primary deposition of amyloid can take several forms including amyloidoma organ restricted among which is brain. Brain amyloidoma can mimic several lesions and offers a diagnostic challenge to the physician. The present work reports an additional case and summarizes the salient characteristics of previously published cases. <strong>Case Report: </strong>A 61-year-old, woman experienced paroxystic auditory hallucinations followed at times by generalized tonico-clonic seizures. Examination revealed a mild left pyramidal weakness. Head CT scan and MRI revealed a lobular lesion of the right atrium with contrast enhancement. The diagnosis of amyloidoma Lambda light chain (λLC) type was performed by means of a stereotactic biopsy. The patient was treated by 3 cures of high dose methotrexate (15 mg/m<sup>2</sup>). At 24 months follow up the patient remains stable clinically and biologically. The 2 years follow-up MRI showed the same findings. <strong>Conclusion: </strong>No guidelines can be suggested for brain amyloidoma treatment;the “wait and see” was the mind-set in the literature. However, a non-tumour like pattern of a cerebral mass developing near the ventricle with a fine, irregular radiating margin enhancement and lack of oedema, and mass effect are important MRI clues for brain amyloidoma diagnosis. The diagnosis is histological after biopsy or excision.
<strong>Introduction: </strong>Primary deposition of amyloid can take several forms including amyloidoma organ restricted among which is brain. Brain amyloidoma can mimic several lesions and offers a diagnostic challenge to the physician. The present work reports an additional case and summarizes the salient characteristics of previously published cases. <strong>Case Report: </strong>A 61-year-old, woman experienced paroxystic auditory hallucinations followed at times by generalized tonico-clonic seizures. Examination revealed a mild left pyramidal weakness. Head CT scan and MRI revealed a lobular lesion of the right atrium with contrast enhancement. The diagnosis of amyloidoma Lambda light chain (λLC) type was performed by means of a stereotactic biopsy. The patient was treated by 3 cures of high dose methotrexate (15 mg/m<sup>2</sup>). At 24 months follow up the patient remains stable clinically and biologically. The 2 years follow-up MRI showed the same findings. <strong>Conclusion: </strong>No guidelines can be suggested for brain amyloidoma treatment;the “wait and see” was the mind-set in the literature. However, a non-tumour like pattern of a cerebral mass developing near the ventricle with a fine, irregular radiating margin enhancement and lack of oedema, and mass effect are important MRI clues for brain amyloidoma diagnosis. The diagnosis is histological after biopsy or excision.
作者
Abd El Kader Moumouni
Daniel Memia Zolo
Essossinam Kpelao
Pascal Compaore
Dabou Abiba Tamou Tabe
Latevi Lawson
Pwerew Rodolphe Plante
Edem Kossi Gueouguede
Benedicte Souho
Abderrahmane Hamlat
Abd El Kader Moumouni;Daniel Memia Zolo;Essossinam Kpelao;Pascal Compaore;Dabou Abiba Tamou Tabe;Latevi Lawson;Pwerew Rodolphe Plante;Edem Kossi Gueouguede;Benedicte Souho;Abderrahmane Hamlat(Department of Neurosurgery, CHU Martinique, Martinique, France;Department of Neurosurgery, CHU Kara, Kara, Togo;Department of Neurosurgery, CHU Sylvanus Olympio, Lomé, Togo;Departments of Radiology, CHR Kara, Kara, Togo)
