6 months later, after XRT and steroids:

Cerebral Amyloidoma

Findings:

CT and MR images demonstrate a poorly defined somewhat flame shaped intraaxial mass within the left thalamus. The mass demonstrates marked T2 hypointensity with surrounding vasogenic edema and mass effect . The lesion is hyperdense on pre-contrast CT.

After radiation therapy and steroids, the mass effect has improved and the enhancing lesion is similar in size.

Discussion:

nLeast common manifestation of CNS amyloid

nMore common: amyloid angiopathy, senile plaques (micro only), deposition in CJD and kuru

nOnly 13 cases reported

nDiagnostic clues

nHyperdense CT, flame shaped, little mass effect, marked T2 hypo, fine irregular spiculated margin

nObviously overlap in appearance with lymphoma, mets, GBM

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