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Costal Amyloidosis: First Case in Literature

Received: 10 July 2024     Accepted: 31 July 2024     Published: 23 September 2024
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Abstract

Amyloidosis is a heterogeneous group of diseases characterized by the extracellular deposition of amyloid proteins in various tissues and organs, which leads to significant morbidity and mortality. The most commonly affected organs include the kidneys, liver, spleen, heart, and nervous system, where the deposition of amyloid proteins disrupts normal function and causes a wide range of clinical manifestations. Involvement of osseous structures, particularly the ribs, is exceedingly rare and has not been extensively documented in the medical literature, making it a subject of significant clinical interest. This study aims to present a rare and fortuitously discovered case of costal amyloidosis in a patient who initially presented with a chest wall mass. The patient’s presentation, diagnostic workup, and subsequent management are detailed to provide a comprehensive overview of this unusual manifestation of amyloidosis. Clinical evaluation revealed a firm, non-tender mass on the chest wall, prompting further investigation. Biological analyses included a series of laboratory tests to rule out common differential diagnoses and identify potential systemic involvement. Radiological evaluation comprised of advanced imaging techniques, including chest X-ray, computed tomography (CT), and magnetic resonance imaging (MRI), which highlighted the nature and extent of the osseous involvement. A biopsy of the mass was performed, and histopathological examination confirmed the diagnosis of amyloidosis through the identification of amyloid deposits using specific staining techniques. The case also examines the evolutionary aspects of the disease, discussing the progression and changes observed over time through regular follow-ups. Therapeutic strategies were implemented based on the latest guidelines and tailored to the patient's specific condition, including both pharmacological and surgical interventions. The short-term and long-term outcomes of these interventions are analyzed, highlighting the challenges and successes encountered during the treatment process. By presenting this case, we aim to shed light on the rare occurrence of costal amyloidosis, its diagnostic challenges, and therapeutic considerations. This case underscores the importance of considering amyloidosis in the differential diagnosis of chest wall masses and contributes to the broader understanding of the disease's clinical spectrum. Additionally, it emphasizes the necessity of a multidisciplinary approach in managing such rare and complex cases, ensuring comprehensive care and improved patient outcomes.

Published in World Journal of Medical Case Reports (Volume 5, Issue 1)
DOI 10.11648/j.wjmcr.20240501.12
Page(s) 13-17
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Chest Wall, Amyloidosis, Rare Disease

References
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[2] Milani P, Basset M, Russo F, Foli A, Palladini G, Merlini G. The lung in amyloidosis. Eur Respir Rev. 2017; 26(145)
[3] Crain MA, Lakhani DA, Balar AB, Hogg JP, Adelanwa A, Hailemichael E. Tracheobronchial amyloidosis: A case report and review of literature. Radiol Case Rep. 2021; 16(9): 2399–2403.
[4] Kapoor R, Bhattacharyya T, Bahl A, Agarwal R, Bal A, Gulati A. Primary amyloidoma of lung treated with radiation: A rare case report. Lung India. 2014; 31(4): 404–406.
[5] Barešić M, Sreter KB, Brčić L, Hećimović A, Janevski Z, Anić B. Solitary pulmonary amyloidoma mimicking lung cancer on 18F-FDG PET-CT scan in systemic lupus erythematosus patient. Lupus. 2015; 24(14): 1546–1551.
[6] Brandelik SC, Heussel CP, Kauczor HU, Rocken C, Huber L, Basset M., et al. CT features in amyloidosis of the respiratory system - Comprehensive analysis in a tertiary referral center cohort. Eur J Radiol. 2020; 129.
[7] Yamada M, Takayanagi N, Yamakawa H, Ishiguiro T, Baba T, Shimizu Y, et al. Amyloidosis of the respiratory system: 16 patients with amyloidosis initially diagnosed ante mortem by pulmonologists. ERJ Open Res. 2020; 6(3): 00313–02019.
[8] Kumar S, Kumar S, Ahmad A, Kumar A. Primary amyloidoma of chest wall–a rare condition. BMJ Case Rep. 2012; 2012
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[10] Iannettoni MD, Wiechmann RJ, Kirsh MM. Primary amyloidoma of the chest wall. Ann Thorac Surg. 1995; 59(6): 1583–1586.
[11] Matsumoto K, Ueno M, Matsuo Y, Kudo S, Horita K, Sakao Y. Primary solitary amyloidoma of the lung: Findings on CT and MRI. Eur Radiol. 1997; 7(4): 586–588.
[12] Kim HY, Im JG, Song KS, Lee KS, Kim SJ, Kim JS, et al. Localized amyloidosis of the respiratory system: CT features. J Comput Assist Tomogr. 1999; 23(4): 627–631.
[13] Fierens J, Mees U, Vanbockrijck M, Hendrikx M. Amyloidoma of the chest wall: A rare entity. Interact Cardiovasc Thorac Surg. 2008; 7(6): 1194–1195.
[14] Sipe JD, Cohen AS. Review: History of the amyloid fibril. J Struct Biol. 2000; 130(2-3): 88–98.
[15] Gillmore JD, Hawkins PN. Amyloidosis and the respiratory tract. Thorax. 1999; 54(5): 444–451.
[16] Lachmann HJ, Hawkins PN. Amyloidosis and the lung. Chron Respir Dis. 2006; 3(4): 203–214.
[17] Tabassomi M, Almasri E, Abdulhaq H. Unusual presentation of pulmonary plasmacytoma and amyloidoma in a patient with multiple myeloma. Am J Respir Crit. 2012; 185: A6649.
[18] Safi S, Op den Winkel J, Schnabel PA, Hegenbart U, Neben K, Schneider T, et al. Extended resection of a plasmacytoma of bone and an amyloidoma of the chest wall. Ann Thorac Surg. 2013; 96(6): 2223–2225.
[19] Sravanthi N, Naveen G, Dinesh J. Primary pulmonary plasmacytoma: Unusual presentation with coexisting amyloidosis and bone metaplasia. Chest. 2014; 146(4): 661A.
Cite This Article
  • APA Style

    Mouad, G., Hachmi, M., Belfkih, I., Ammor, F., Makloul, M., et al. (2024). Costal Amyloidosis: First Case in Literature. World Journal of Medical Case Reports, 5(1), 13-17. https://doi.org/10.11648/j.wjmcr.20240501.12

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    ACS Style

    Mouad, G.; Hachmi, M.; Belfkih, I.; Ammor, F.; Makloul, M., et al. Costal Amyloidosis: First Case in Literature. World J. Med. Case Rep. 2024, 5(1), 13-17. doi: 10.11648/j.wjmcr.20240501.12

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    AMA Style

    Mouad G, Hachmi M, Belfkih I, Ammor F, Makloul M, et al. Costal Amyloidosis: First Case in Literature. World J Med Case Rep. 2024;5(1):13-17. doi: 10.11648/j.wjmcr.20240501.12

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  • @article{10.11648/j.wjmcr.20240501.12,
      author = {Gourti Mouad and Mohammed Hachmi and Imane Belfkih and Fatimezzahra Ammor and Mouhssine Makloul and Maidi Elmehdi},
      title = {Costal Amyloidosis: First Case in Literature
    },
      journal = {World Journal of Medical Case Reports},
      volume = {5},
      number = {1},
      pages = {13-17},
      doi = {10.11648/j.wjmcr.20240501.12},
      url = {https://doi.org/10.11648/j.wjmcr.20240501.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjmcr.20240501.12},
      abstract = {Amyloidosis is a heterogeneous group of diseases characterized by the extracellular deposition of amyloid proteins in various tissues and organs, which leads to significant morbidity and mortality. The most commonly affected organs include the kidneys, liver, spleen, heart, and nervous system, where the deposition of amyloid proteins disrupts normal function and causes a wide range of clinical manifestations. Involvement of osseous structures, particularly the ribs, is exceedingly rare and has not been extensively documented in the medical literature, making it a subject of significant clinical interest. This study aims to present a rare and fortuitously discovered case of costal amyloidosis in a patient who initially presented with a chest wall mass. The patient’s presentation, diagnostic workup, and subsequent management are detailed to provide a comprehensive overview of this unusual manifestation of amyloidosis. Clinical evaluation revealed a firm, non-tender mass on the chest wall, prompting further investigation. Biological analyses included a series of laboratory tests to rule out common differential diagnoses and identify potential systemic involvement. Radiological evaluation comprised of advanced imaging techniques, including chest X-ray, computed tomography (CT), and magnetic resonance imaging (MRI), which highlighted the nature and extent of the osseous involvement. A biopsy of the mass was performed, and histopathological examination confirmed the diagnosis of amyloidosis through the identification of amyloid deposits using specific staining techniques. The case also examines the evolutionary aspects of the disease, discussing the progression and changes observed over time through regular follow-ups. Therapeutic strategies were implemented based on the latest guidelines and tailored to the patient's specific condition, including both pharmacological and surgical interventions. The short-term and long-term outcomes of these interventions are analyzed, highlighting the challenges and successes encountered during the treatment process. By presenting this case, we aim to shed light on the rare occurrence of costal amyloidosis, its diagnostic challenges, and therapeutic considerations. This case underscores the importance of considering amyloidosis in the differential diagnosis of chest wall masses and contributes to the broader understanding of the disease's clinical spectrum. Additionally, it emphasizes the necessity of a multidisciplinary approach in managing such rare and complex cases, ensuring comprehensive care and improved patient outcomes.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Costal Amyloidosis: First Case in Literature
    
    AU  - Gourti Mouad
    AU  - Mohammed Hachmi
    AU  - Imane Belfkih
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    AU  - Mouhssine Makloul
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    DO  - 10.11648/j.wjmcr.20240501.12
    T2  - World Journal of Medical Case Reports
    JF  - World Journal of Medical Case Reports
    JO  - World Journal of Medical Case Reports
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    PB  - Science Publishing Group
    SN  - 2994-726X
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    AB  - Amyloidosis is a heterogeneous group of diseases characterized by the extracellular deposition of amyloid proteins in various tissues and organs, which leads to significant morbidity and mortality. The most commonly affected organs include the kidneys, liver, spleen, heart, and nervous system, where the deposition of amyloid proteins disrupts normal function and causes a wide range of clinical manifestations. Involvement of osseous structures, particularly the ribs, is exceedingly rare and has not been extensively documented in the medical literature, making it a subject of significant clinical interest. This study aims to present a rare and fortuitously discovered case of costal amyloidosis in a patient who initially presented with a chest wall mass. The patient’s presentation, diagnostic workup, and subsequent management are detailed to provide a comprehensive overview of this unusual manifestation of amyloidosis. Clinical evaluation revealed a firm, non-tender mass on the chest wall, prompting further investigation. Biological analyses included a series of laboratory tests to rule out common differential diagnoses and identify potential systemic involvement. Radiological evaluation comprised of advanced imaging techniques, including chest X-ray, computed tomography (CT), and magnetic resonance imaging (MRI), which highlighted the nature and extent of the osseous involvement. A biopsy of the mass was performed, and histopathological examination confirmed the diagnosis of amyloidosis through the identification of amyloid deposits using specific staining techniques. The case also examines the evolutionary aspects of the disease, discussing the progression and changes observed over time through regular follow-ups. Therapeutic strategies were implemented based on the latest guidelines and tailored to the patient's specific condition, including both pharmacological and surgical interventions. The short-term and long-term outcomes of these interventions are analyzed, highlighting the challenges and successes encountered during the treatment process. By presenting this case, we aim to shed light on the rare occurrence of costal amyloidosis, its diagnostic challenges, and therapeutic considerations. This case underscores the importance of considering amyloidosis in the differential diagnosis of chest wall masses and contributes to the broader understanding of the disease's clinical spectrum. Additionally, it emphasizes the necessity of a multidisciplinary approach in managing such rare and complex cases, ensuring comprehensive care and improved patient outcomes.
    
    VL  - 5
    IS  - 1
    ER  - 

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Author Information
  • Chest Surgery Department, Hospital Center Hassan 2, Agadir, Morocco; Surgery Laboratory, Medical University, Agadir, Morocco

  • Chest Surgery Department, Hospital Center Hassan 2, Agadir, Morocco; Surgery Laboratory, Medical University, Agadir, Morocco

  • Chest Surgery Department, Hospital Center Hassan 2, Agadir, Morocco; Surgery Laboratory, Medical University, Agadir, Morocco

  • Chest Surgery Department, Hospital Center Hassan 2, Agadir, Morocco; Surgery Laboratory, Medical University, Agadir, Morocco

  • Chest Surgery Department, Hospital Center Hassan 2, Agadir, Morocco; Surgery Laboratory, Medical University, Agadir, Morocco

  • Chest Surgery Department, Hospital Center Hassan 2, Agadir, Morocco; Surgery Laboratory, Medical University, Agadir, Morocco

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