Calcified amyloid tumor of neck with exuberant giant cell reaction

Abstract

Amyloidosis is a group of disorders characterized by an extracellular deposition of an abnormal amount of proteins in a variety of organs resulting from abnormal folding of protein. It typically presents as disseminated deposits. Tumor like localized presentation of amyloidosis in the absence of systemic amyloidosis is referred to as amyloidoma or amyloid tumor. Amyloidoma is the least common presentation of tissue amyloid deposition. Amyloidoma of soft tissue is again a very rare entity, especially in the neck region. Calcification and minimum giant cell reaction can occur in amyloidoma. However, extensive calcification and exuberant giant cell reaction in amyloidoma of soft tissue neck make it difficult to diagnose. In this report, we discuss such a rare case with its differential diagnoses.

Keywords: Amyloidoma; amyloidosis; giant cell; neck.

Figure 1

(a and b) Computed tomography with contrast of neck showing a large enhancing well circumscribed solid calcified mass lesion on right side of neck extending from C2 to D2 vertebral level

Figure 2

Gross appearance of amyloidoma, showing well circumscribed but un-encapsulated brown colored tumor mass

Figure 3

(a) The section showing amorphous eosinophilic deposit of amyloid and exuberant giant cell reaction around the deposit (H and E, ×400). (b) The extracellular amyloid deposit show negative staining with Van Gieson stain (×100). (c) Extra cellular amyloid material staining positively with Congo red (×400). (d) The deposit is showing faint apple-green birefringence on polarization (×400)