Spontaneous Remission Of Untreated Primary Amyloidosis Of The Bladder After Transurethral Resection Biopsy: A Case Report And Literature Review
Jia, Y., Li, S., & Liu, J. (2020). Spontaneous remission of untreated primary amyloidosis of the bladder after transurethral resection biopsy: a case report and literature review. The Journal of international medical research, 48(10), 300060520940452. https://doi.org/10.1177/0300060520940452
View Original Source →Abstract
We herein present a case involving a 23-year-old woman with gross hematuria. Cystoscopy revealed abnormal areas of the mucosa along the anterior and posterior bladder walls. These abnormalities were suspicious for neoplasia; however, a diagnosis was not established by subsequent biopsy. The patient underwent transurethral resection biopsy in which an isolated lesion along the anterior wall was completely resected and the others were left untreated. Pathologic examination and special staining led to a diagnosis of amyloidosis, and the patient elected to undergo transurethral surgery 1 month later. During the operation, the intravesical lesions were found to have significantly improved in both the treated and untreated sites. The operation was cancelled, follow-up was arranged, and no other treatment was administered. Repeat cystoscopy examinations at 3 and 9 months after surgery showed that the lesions had almost completely disappeared.
Case Details
Disease Location
Bladder
Personal Characteristics
23-year-old woman
Clinical Characteristics
20-day history of gross hematuria. Ureteral computed tomography showed thickening of the left anterior and posterior walls of the bladder. Cystoscopic examination revealed multiple lesions and obvious vessel engorgement on the anterior and posterior walls of the bladder. The base was wide and bulging, showing a crater-like appearance. The largest diameter of the base was about 3.0 cm. Biopsy demonstrated urothelial tissue hyperplasia and interstitial degeneration with edema. Transurethral resection of an isolated lesion was performed. Pathologic examination showed amyloid depositions in the subcutaneous interstitium of the urothelium. 1 month later, the patient underwent transurethral resection of the bladder lesion
Remission Characteristics
During the operation, the intravesical lesions were found to have significantly improved. Repeat cystoscopy 3 months after the resection biopsy showed that the lesions had nearly disappeared.
Treatment & Mechanisms
Proposed Remission Mechanisms
Localized bladder amyloidosis can spontaneously resolve without treatment
Clinical Treatment
Biopsy, transurethral resection
Non-Clinical Treatment
None reported