Primary localized amylodoisis of bladder: Is there a need for cystoscopic surveillance?
A 78-year-old gentleman attended hematuria clinic with two weeks history of intermittent, macroscopic hematuria which was associated with irritative lower urinary tract symptoms. Ultrasound scan of kidney and bladder revealed normal appearing kidneys bilaterally with slight thickening of the bladder, which was confirmed by CT scan []. A flexible cystoscopy showed a craggy appearing solid lesion with some hemorrhagic areas situated over the trigone of bladder and was not involving ureteric, resembling invasive bladder tumour. Transurethral resection was performed and submitted for histological examination. Histology was reported as primary (AL) amyloid and there was no evidence of either in situ or invasive urothelial malignancy. Systematic investigations were performed which were negative for systemic amyloidosis. There was no recurrence of vesical amylodosis and he remains asymptomic 4.5 years after initial diagnosis.