Treatment features of localised bladder amyloidosis: case report and literature review

Local amyloidosis of the bladder is a rare disease characterized by the colonization of the bladder wall by an abnormal clone of plasma cells that produce amyloidogenic immunoglobulin light chains. According to modern classification, this condition is classified as AL amyloidosis (A for amyloidosis, L for light chains of immunoglobulins). In cases of local amyloidosis, the amyloidogenic light chains of immunoglobulins are not present in the bloodstream, as the clone functions locally in the tissue and the synthesized immunoglobulins are retained by the interstitial tissue. As a result, plasma cells encased in amyloid are not accessible to chemotherapy. Due to this limitation, chemotherapy is not a viable treatment option for local amyloidosis. Radiation therapy is also not recommended as it could cause significant damage to the regenerative capacity of the bladder wall, leading to a reduction in mechanical strength and functionality. Therefore, the primary treatment method for local amyloidosis of the bladder is transurethral resection. In cases of recurrent forms, patients may be offered open or laparoscopic resection of the bladder wall or cystectomy. This case study presents a clinical observation of a patient with local amyloidosis of the bladder, highlighting the challenges in diagnosis and discussing potential approaches to surgical treatment.