PET-Florbetapir findings in primary cerebral amyloidoma.

Amyloidosis is a heterogeneous group of diseases characterized by the extracellular deposition of an amorphous material, composed of insoluble fibrillar proteins. Cerebral amyloidoma is a type of localized amyloidosis that can rarely affect the brain, with around 30 cases described in the literature [1–5]. Florbetapir is an amyloid radioligand developed to support diagnosis of Alzheimeŕs disease [6, 7]. Its role in the diagnosis of other cerebral amyloidosis has to be further defined. To our knowledge, this is the first report of PET-Florbetapir findings in cerebral amyloidoma. A 51-year-old man was admitted after presenting with two complex partial seizures. His wife reported mild difficulties to carry out demanding tasks in the last year. Neurological examination demonstrated an impairment of executive funtion and ideomotor apraxia. A CT scan showed multifocal hyperdense lesions, most prominent in the cerebellum, right frontal and left parietal white matter, with contrast enhancement. On MRI, these lesions were isointense with the white matter on T1-weighted images, hyperintense on T2-weighted images, and showed intense contrast enhancement, with a pattern of irregular lines radiating from the ventricular wall (Fig. 1a). Comprehensive evaluation including CSF examination did not reveal any other abnormalities. Stereotactic brain biopsy of the left parietal white matter showed nodular, confluent amyloid masses. With hematoxilin-eosin they consisted of homogeneneous eosinofilic material, showed apple-green birefringence upon polarization with Congo-red staining (Fig. 1b) and intense