• World Neurosurg · Jun 2020

    Review Case Reports

    Minimally invasive resection of intracerebral amyloidoma; case report and systematic review of the literature.

    • David P Bray, Christopher W Rich, Jason A Ellis, Gustavo Pradilla, and Daniel L Barrow.
    • Department of Neurosurgery, Emory University Medical Center, Atlanta, Georgia, USA. Electronic address: dpaintonbray@gmail.com.
    • World Neurosurg. 2020 Jun 1; 138: 205-213.

    BackgroundManagement of cerebral amyloidomas has lacked consensus owing to their rarity. We present a case and review 39 reported cases of amyloidomas in the literature, comparing their initial presentation, imaging characteristics, treatment, and progression.Case DescriptionA 56-year-old woman presented with a history of intractable headaches and progressive speech difficulty. Imaging demonstrated a 1.7 × 2.6 cm left frontal subcortical hemorrhagic mass with an associated developmental venous anomaly, characteristics initially suggestive of a cavernous malformation. Diffusion tractography imaging was employed to avoid interference with the intact arcuate fasciculus and corticospinal tracts to minimize neurologic deficits.ConclusionsTo our knowledge, this is the first documented case of the use of diffusion tractography in preoperative planning for cerebral amyloidoma resection. Our systematic review of 39 reported cases of amyloidomas in the literature provided insight regarding how these rare lesions have manifested and progressed and further understanding of current theories regarding their etiology and pathophysiology. Cerebral amyloidomas are rare, localized, proteinaceous aggregates with variable presentation and prognosis and no apparent relationship to systemic amyloidosis. Biopsy may be useful in determination of progression. Diffusion tractography is a valuable tool for minimizing complications associated with resection.Copyright © 2020 Elsevier Inc. All rights reserved.

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