Progression of dialysis-related amyloidoma towards pathologic fracture

Skeletal Radiol. 2019 Feb;48(2):301-306. doi: 10.1007/s00256-018-3009-2. Epub 2018 Jun 26.

Abstract

Amyloidosis is the extracellular deposition of amyloid protein fibrils, and this condition may be hereditary or acquired. Patients undergoing long-term hemodialysis are particularly at risk for developing acquired amyloidosis. A rare form of amyloidosis is an amyloidoma or amyloid tumor, which occurs when amyloid focally deposits in a section of the musculoskeletal system, most commonly in the osteoarticular system. Here, we present a case of a hemodialysis-related amyloidoma of the left femoral neck in an 80-year-old woman with end-stage renal disease on hemodialysis for 8 years. The purpose of this report is to provide an account of the unique clinical, imaging, and histopathologic manifestation of a dialysis-related amyloidoma that progressively enlarges over a 2-year period. This report also highlights some prophylactic measures that may reduce the risk of developing an associated pathologic fracture.

Keywords: Amyloidoma; Dialysis; Pathologic fracture.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Amyloidosis / diagnostic imaging*
  • Amyloidosis / etiology*
  • Arthroplasty, Replacement, Hip
  • Diabetes Mellitus, Type 2
  • Diagnosis, Differential
  • Disease Progression
  • Female
  • Fractures, Spontaneous / diagnostic imaging*
  • Fractures, Spontaneous / etiology*
  • Fractures, Spontaneous / surgery
  • Hip Fractures / diagnostic imaging*
  • Hip Fractures / etiology*
  • Hip Fractures / surgery
  • Humans
  • Incidental Findings
  • Kidney Failure, Chronic / therapy
  • Magnetic Resonance Imaging*
  • Renal Dialysis / adverse effects*
  • Tomography, X-Ray Computed*