Trigeminal Amyloidoma: A Report of Two Cases and Review of the Literature

Long-Term Progression of a Residual Cerebral Amyloidoma: An Illustrative Case and Systematic Review

OBJECTIVE

Cerebral amyloidomas (CA) are exceptionally rare tumor-like lesions composed of cerebral amyloid-beta, which is derived from the cleavage of the amyloid precursor protein.

METHODS

We presented a case of recurrent CA and performed a systematic review, comparing their initial presentation, imaging features, neurosurgical treatment, and natural history of the disease.

ILLUSTRATIVE CASE

A 65-year-old male with a history of right homonymous hemianopsia, who underwent subtotal resection of a CA 19 years before, presents to the emergency department with right hemiparesis, dysarthria, and a new onset of clonic seizures. Imaging revealed a left parieto-occipital lesion with calcifications and vasogenic edema. A gross-total resection was performed. Histopathology revealed a hypocellular eosinophilic lesion consistent with CA. Postoperatively, the patient recovered without new neurological deficits. One-year follow-up magnetic resonance imaging showed no residual or recurrence lesion.

SEARCH RESULTS

Eighty-seven cases, including ours, revealed that 65.5% (n = 57) were females with a median age of 54 years (IQR: 46-62). Most lesions were solitary (82.7%; 72 of 87 lesions). Frontal and parietal lobes were most commonly affected with 32.9% (n = 28) and 30.5% (n = 26), respectively. Seizures were the most common symptom followed by visual compromise. Calcifications were present in 19.5% (n = 17) of the lesions.

CONCLUSIONS

This systematic review provides insights into the epidemiological, clinical, and neurosurgical characteristics, as well as the long-term prognosis of CA. This marks the first case in the reviewed literature with a 19-year period of follow-up where the patient had reoperation due to disease progression.

A Case of Bilateral Trigeminal Amyloidoma Diagnosed Through an Endoscopic Transsphenoidal Approach

Amyloidosis is a systemic disease characterized by the accumulation of amyloid protein in multiple organs. Amyloidoma, in contrast, is an uncommon localized form of amyloidosis that presents as a single mass or tumor-like lesion. Primary amyloidoma in the central nervous system is rare, and only a few cases have been reported. Notably, the Gasserian ganglion is the most frequently affected site of amyloidoma in the central nervous system, and progressive trigeminal neuropathy is a characteristic finding. Among these cases, the bilateral occurrence of amyloidoma is exceedingly rare. In this report, we present the case of a 51-year-old woman diagnosed with bilateral trigeminal amyloidoma, confirmed by an endoscopic biopsy via the transsphenoidal approach.

Trigeminal Amyloidoma in a Patient With Cardiac Amyloidosis

Trigeminal amyloidoma is a rare clinical phenomenon with scarce reports in the medical literature. This report presents a case of biopsy-proven trigeminal amyloidoma in a patient with cardiac amyloidosis. This case report sheds light on the differential diagnoses that may resemble trigeminal amyloidoma and strategies for workup and treatment.