TY - JOUR
T1 - Bilateral trigeminal amyloidoma
T2 - An unusual case of trigeminal neuropathy with a review of the literature. Case report
AU - O'Brien, T. J.
AU - McKelvie, P. A.
AU - Vrodos, N.
PY - 1994/1/1
Y1 - 1994/1/1
N2 - Isolated amyloidomas may albeit rarely, involve the central nervous system. There are three previous reports of amyloidomas that involved the gasserian ganglion and caused unilateral trigeminal neuropathies. The authors report the case of a 49-year-old woman with apparently isolated amyloidomas that caused slowly progressive bilateral trigeminal neuropathies. Magnetic resonance imaging of the brain revealed mild swelling of the left trigeminal nerve within the cavernous sinus and uniform enhancement with gadolinium throughout the length of the nerve. At craniotomy, the trigeminal nerve and ganglion were observed to be infiltrated by a tumor-like mass. Biopsy showed extensive infiltration of the nerve and ganglion by amyloid. Immunocytochemical studies of the amyloid were negative for immunoglobulins, κ and λ light chains, β-amyloid A4 protein, transthyretin, β2- microglobulin, cystatin C, and gelsolin, but weak focal immunoreactivity with antiamyloid AA antibody was seen in the amyloid in vessels and in some intraneural deposits. Extensive investigations failed to reveal evidence of either systemic amyloidoses or an underlying inflammatory disorder or malignancy.
AB - Isolated amyloidomas may albeit rarely, involve the central nervous system. There are three previous reports of amyloidomas that involved the gasserian ganglion and caused unilateral trigeminal neuropathies. The authors report the case of a 49-year-old woman with apparently isolated amyloidomas that caused slowly progressive bilateral trigeminal neuropathies. Magnetic resonance imaging of the brain revealed mild swelling of the left trigeminal nerve within the cavernous sinus and uniform enhancement with gadolinium throughout the length of the nerve. At craniotomy, the trigeminal nerve and ganglion were observed to be infiltrated by a tumor-like mass. Biopsy showed extensive infiltration of the nerve and ganglion by amyloid. Immunocytochemical studies of the amyloid were negative for immunoglobulins, κ and λ light chains, β-amyloid A4 protein, transthyretin, β2- microglobulin, cystatin C, and gelsolin, but weak focal immunoreactivity with antiamyloid AA antibody was seen in the amyloid in vessels and in some intraneural deposits. Extensive investigations failed to reveal evidence of either systemic amyloidoses or an underlying inflammatory disorder or malignancy.
KW - amyloidoma
KW - central nervous system
KW - differential diagnosis
KW - trigeminal neuropathy
UR - http://www.scopus.com/inward/record.url?scp=0028020615&partnerID=8YFLogxK
U2 - 10.3171/jns.1994.81.5.0780
DO - 10.3171/jns.1994.81.5.0780
M3 - Article
C2 - 7931626
AN - SCOPUS:0028020615
SN - 0022-3085
VL - 81
SP - 780
EP - 783
JO - Journal of Neurosurgery
JF - Journal of Neurosurgery
IS - 5
ER -