INTRODUCTION: 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. CLINICAL PRESENTATION: 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. CONCLUSION: 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.
INTRODUCTION: 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. CLINICAL PRESENTATION: 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. CONCLUSION: 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: K Nokura; H Koga; H Yamamoto; A Kimura; H Tamai; S Yazaki; N Suzuki; S Miyazaki; T Niwa Journal: J Neurol Sci Date: 2000-09-15 Impact factor: 3.181