Angiopatia amilóide cerebral simulando tumor cerebral: relato de caso

Andrade, Gustavo Cardoso de; Silveira, Roberto Leal; Pinheiro, N.; Rocha, Eckstânio Marcos Melo; Pittella, José Eymard Homem

doi:10.1590/s0004-282x2006000100034

Cited by 6 publications

(4 citation statements)

References 13 publications

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“…Other immune modulating therapies, including azathioprine and intravenous immunoglobulin, were used in 10% of cases. Other treatments, including surgical resection of the abnormal area of the brain, 19,45,57,60,83,97,105 were employed in 8% of cases.…”

Section: Treatmentmentioning

confidence: 99%

Cerebral amyloid angiopathy associated with inflammation: A systematic review of clinical and imaging features and outcome

Ćorović

Kelly

Markus

2017

International Journal of Stroke

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Background Cerebral amyloid angiopathy associated with inflammation is an increasingly recognized condition, characterized by an inflammatory response to the vascular deposits of β-amyloid within the brain that are the hallmark of cerebral amyloid angiopathy. Two main patterns of this inflammatory response have been identified to date: one involving a perivascular inflammatory cell infiltrate (cerebral amyloid angiopathy-related inflammation); the other a transmural vasculitic process (A-beta related angiitis). Unlike cerebral amyloid angiopathy itself, which predisposes to intracerebral hemorrhage and has no known treatment, cerebral amyloid angiopathy associated with inflammation typically presents in diverse ways and diagnosis may be challenging and delayed. Aims We sought to summarize the clinical features, imaging appearances and available data on outcome and treatment responses, using information derived from a systematic review of pathologically proven cases of cerebral amyloid angiopathy associated with inflammation. Summary of review We identified 213 distinct pathologically proven cases of cerebral amyloid angiopathy-related inflammation/A-beta related angiitis, from 104 publications. The clinical presentation, imaging features, pathology, treatment, and outcomes of cerebral amyloid angiopathy associated with inflammation are described. Conclusions Cerebral amyloid angiopathy associated with inflammation is an important and increasingly recognized clinical condition, which affects the older patient population and presents most commonly with cognitive decline, seizures, and headaches. Future research is required to develop and validate diagnostic criteria and determine optimum treatment strategies.

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Section: Treatmentmentioning

confidence: 99%

Cerebral amyloid angiopathy associated with inflammation: A systematic review of clinical and imaging features and outcome

Ćorović

Kelly

Markus

2017

International Journal of Stroke

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“…Realizamos una revisión en las principales bases de datos (Pubmed, Embase, Lilacs y Scielo) y sólo encontramos cinco casos reportados en Latinoamérica con AAC o AAC-IR, uno en México 12 , uno en Uruguay 13 y dos en Brasil 14,15 no relacionados con inflamación y el quinto caso en Argentina asociado a inflamación 16 . En Colombia no encontramos ningún caso reportado de AAC con o sin inflamación.…”

Section: Discussionunclassified

Angiopatía amiloide cerebral con inflamación relacionada y demencia rápidamente progresiva: primer reporte de caso en Colombia

Zapata Zapata,

Franco Dáger,

Arango Viana

2016

Acta Neurol Colomb

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La angiopatía amiloide cerebral (AAC) consiste en el depósito de amiloide en la pared de los vasos sanguíneos intracraneales, y conlleva a la aparición de hemorragia, isquemia o leucoencefalopatía. Las manifestaciones clínicas de la AAC son muy variables, tales como alteraciones cognitivas, alteraciones comportamentales, déficit neurológico focal, cefalea o crisis epilépticas. Un subtipo de angiopatía amiloide cerebral con inflamación relacionada (AAC-IR), se ha reportado recientemente en la literatura mundial. Presentamos el caso de una paciente de 74 años de edad, con un cuadro de demencia rápidamente progresiva de aproximadamente tres meses de evolución, asociada a cefalea, meningismo, disminución de la fuerza en hemicuerpo derecho, múltiples lesiones hemorrágicas parenquimatosas, hemosiderosis difusa, edema cerebral focal y estudio histológico con evidencia de amiloide intracerebral. El diagnóstico de la AAC se basa en una historia clínica compatible; neuroimagenes que demuestren hemosiderosis o múltiples hemorragias de predominio en fosa posterior, y en algunos casos estudio histológico que confirme la presencia de amiloide en la microcirculación intracraneal. Los criterios de Boston modificados unifican los hallazgos para el diagnóstico de AAC con diferentes grados de certeza. En algunas ocasiones, como en el caso presentado, la AAC se asocia a un componente inflamatorio, y se manifiesta con una demencia rápidamente progresiva, constituyéndose en un verdadero reto diagnóstico.

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“…Central nervous system amyloidoma is a different entity from systemic amyloidosis or from the more common congophilic amyloid angiopathy [19] both histopathologically and radiologically. tCAA refers to diffuse parenchymal deposition of amyloid with a focal mass like lesion which mostly involve the wall of cortical and leptomeningeal arteries, usually sparing the white matter except in the sub-cortical zones [73] [74] [75], in contrast amyloidoma is a focal deposition of amyloid mostly found within the white matter. In addition, on post-contrast imaging, amyloidoma invariably shows post-contrast enhancement, whereas tCAA usually does not [73] [74] [75].…”

Section: Differential Diagnosismentioning

confidence: 99%

“…Localized amyloidomas seem to have no documented risk for increased mortality. Unlike CAA, in which the risk of intracranial haemorrhage is known to be high [73] [74] [75], the risk of haemorrhage in brain amyloidoma is undetermined; brain haemorrhage has occurred in two patients [18] [29] and microscopic foci of haemorrhage have been described in another case [16]. There has been no observed malignant transformation or other pathology related to amyloidoma although scarcely the development of systemic disease several years after initial diagnosis of amyloidoma has been reported [55] [66].…”

Section: Follow Upmentioning

confidence: 99%

Brain Amyloidoma: Case Report and Literature Review

Moumouni¹,

Zolo²,

Kpelao³

et al. 2020

OJMN

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Introduction: Primary deposition of amyloid can take several forms including amyloidoma organ restricted among which is brain. Brain amyloidoma can mimic several lesions and offers a diagnostic challenge to the physician. The present work reports an additional case and summarizes the salient characteristics of previously published cases. Case Report: A 61-year-old, woman experienced paroxystic auditory hallucinations followed at times by generalized tonico-clonic seizures. Examination revealed a mild left pyramidal weakness. Head CT scan and MRI revealed a lobular lesion of the right atrium with contrast enhancement. The diagnosis of amyloidoma Lambda light chain (λLC) type was performed by means of a stereotactic biopsy. The patient was treated by 3 cures of high dose methotrexate (15 mg/m 2 ). At 24 months follow up the patient remains stable clinically and biologically. The 2 years follow-up MRI showed the same findings. Conclusion: No guidelines can be suggested for brain amyloidoma treatment; the "wait and see" was the mind-set in the literature. However, a non-tumour like pattern of a cerebral mass developing near the ventricle with a fine, irregular radiating margin enhancement and lack of oedema, and mass effect are important MRI clues for brain amyloidoma diagnosis. The diagnosis is histological after biopsy or excision.

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Angiopatia amilóide cerebral simulando tumor cerebral: relato de caso

Cited by 6 publications

References 13 publications

Cerebral amyloid angiopathy associated with inflammation: A systematic review of clinical and imaging features and outcome

Cerebral amyloid angiopathy associated with inflammation: A systematic review of clinical and imaging features and outcome

Angiopatía amiloide cerebral con inflamación relacionada y demencia rápidamente progresiva: primer reporte de caso en Colombia

Brain Amyloidoma: Case Report and Literature Review

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