Cervical Amyloidoma Successfully Treated With Bortezomib and Dexamethasone

Abstract

neurologic sequelae. Treatment is typically neurosurgical. Chemotherapy is typically employed when suppression of systemic amyloidosis is required. 4, ortezomib is a first-generation proteosome inhibitor, which has demonstrated clinical utility in multiple myeloma. Kastritis et al 1 demonstrated a 47% complete response rate when this agent was used-with or without dexamethasone-to treat systemic light chain amyloidosis. Other groups have also demonstrated clinical utility of this agent in systemic amyloidosis. Wechalekar et al 7 described 15% complete hematologic response and 65% partial response rates. A 20% complete hematologic response rate was demonstrated in a phase I dose-finding study using single-agent bortezomib. his report, to our knowledge, describes the first use of this agent to treat isolated amyloidoma. The treatment was well tolerated in our patient, with significant clinical benefit. The rarity of this condition makes standard randomized, controlled trials difficult to perform. We suggest that bortezomib and dexamethasone may be clinically useful, especially in cases in which standard surgical approaches are not appropriate.