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Hemodialysis-related upper cervical extradural amyloidoma presenting with intractable radiculopathy

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Abstract

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.

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Authors and Affiliations

  1. Department of Neurosurgery, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan

    Yasuhiro Takeshima, Masashi Kotsugi, Young-Su Park & Hiroyuki Nakase

Authors
  1. Yasuhiro Takeshima
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  2. Masashi Kotsugi
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  3. Young-Su Park
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  4. Hiroyuki Nakase
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Correspondence to Yasuhiro Takeshima.

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Takeshima, Y., Kotsugi, M., Park, YS. et al. Hemodialysis-related upper cervical extradural amyloidoma presenting with intractable radiculopathy. Eur Spine J 21 (Suppl 4), 463–466 (2012). https://doi.org/10.1007/s00586-011-2084-z

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  • DOI: https://doi.org/10.1007/s00586-011-2084-z

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