Department of Orthopedic Surgery, Osaka National Hospital, 2-1-14 Hoenzaka Chuo-ku Osaka, Osaka 5400006, Japan.
Spine J. 2013 Oct;13(10):e27-30. doi: 10.1016/j.spinee.2013.05.051. Epub 2013 Jul 23.
Localized amyloid deposits result in a mass, that is, so-called amyloidoma; it has been reported in every anatomic site, although systemic amyloid deposition is much more common. However, primary lumbar epidural amyloidoma without bony involvement is extremely rare. To the best of our knowledge, only one case has been reported previously.
To report and review the clinical presentations, imaging studies, and treatment of epidural and paravertebral amyloidoma.
A case report and review of the literature.
Lumbar epidural and paravertebral amyloidoma in a 75-year-old man with neurologic compromise is presented. Laminectomy with mass resection was performed.
After surgery, almost complete neurologic improvement was observed. Histologically, definite diagnosis was obtained only after the specific staining of tissue. No sign of local recurrence was evident 1 year after surgery.
Primary amyloidoma, although rare, should be included in the differential diagnosis of epidural mass of the spine. Diagnosis before surgery is difficult as there were no characteristic findings in clinical and imaging studies. Special histologic technique and stains are useful to make a definite diagnosis.
局部淀粉样沉积物会导致肿块，即所谓的淀粉样瘤；它已在每个解剖部位报告过，尽管全身性淀粉样沉积更为常见。然而，没有骨受累的原发性腰椎硬膜外淀粉样瘤极其罕见。据我们所知，以前仅报告过一例。
报告和回顾硬膜外和椎旁淀粉样瘤的临床表现、影像学研究和治疗。
病例报告和文献复习。
报告一例 75 岁男性伴有神经功能障碍的腰椎硬膜外和椎旁淀粉样瘤。行椎板切除术和肿块切除术。
手术后，几乎完全观察到神经功能改善。仅在组织的特殊染色后才能获得明确的诊断。手术后 1 年无局部复发迹象。
尽管原发性淀粉样瘤罕见，但应将其纳入脊柱硬膜外肿块的鉴别诊断。由于在临床和影像学研究中没有特征性发现，因此术前诊断困难。特殊的组织学技术和染色有助于明确诊断。
