Primary amyloidoma of the thoracic spine presenting with acute paraplegia

BACKGROUND Primary solitary amyloidoma of the spine is a rare disease characterized by localized deposition of amyloid. To the best of our knowledge, there have been only 14 cases previously reported in the literature. Patients with foc al spinal amyloidoma usually have relatively long symptomatic periods preop eratively, ranging from 3 weeks to 6 years (mean: 12 months). Only two repo rted patients had acute paraplegia. We add a third case of a thoracic spine amyloidoma presenting with acute paraplegia. CASE DESCRIPTION A 65-year-old man presented with a three-day history of progressive paraple gia and urinary retention. He was found to have severe cord compression at T2 on magnetic resonance imaging. He underwent emergent decompressive lamin ectomy with instrumentation for spinal stabilization. Histopathology reveal ed abundant amyloid deposits. A systemic work-up was negative for amyloidos is. The patient showed marked neurological improvement with residual mild s pastic gait after 1 year. CONCLUSIONS Primary spinal amyloidoma with acute paraplegia is rare. One-stage surgery combining prompt decompression and stabilization of the spinal column is ma ndatory in cases of spinal amyloidoma. with acute myelopathy, because prima ry solitary amyloidoma carries a good prognosis. (C) 2001 by Elsevier Scien ce Inc.