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.