Hypothalamic amyloidoma

Case contributed by Rebecca Dumont Walter


One year history of central hypothyroidism of unknown etiology.

Patient Data

Age: 55 years
Gender: Male

Contrast-enhanced MRI Brain


Centered within the right greater than left thalamus/hypothalamus, there are multiple ill-defined punctate and ringlike foci of enhancement with T2 hypointense signal. These areas are surrounded by patchy, minimally expansile T2 hyperintensity throughout the anterior perforated substance, hypothalamus, optic tracts, internal capsules, putamina and ventral thalami. 

Case Discussion

This is a biopsy-proven case of hypothalamic amyloidoma. Differential considerations for this appearance would include a granulomatous process such as neurosarcoidosis, infection or an atypical appearance of CNS lymphoma

Amyloid deposition within the brain can take many forms, including cerebral amyloid angiopathy, senile plaques of Alzheimer dementia, deposits seen in the encephalopathy of Kuru and of Creutzfeldt-Jacob disease, or tumor-like focal deposits known as amyloidomas. The latter is the most rare form of cerebral amylodosis, with only a small number of case reports in the literature. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.