title: Occlusive dressing therapy using dimethyl sulfoxide in a patient presenting with primary localized amyloidosis of the urinary bladder: a case report.
abstract: BACKGROUND
  Amyloidosis is characterized by extracellular deposition of abnormal insoluble fibrils, which cause structural and functional disorders. Amyloidosis is classified into primary and secondary disease. We report a case of localized amyloidosis of the urinary bladder. In the English literature, this is the first case effectively treated with occlusive dressing therapy using dimethyl sulfoxide.
  
  
  METHODS
  A 58-year-old Japanese woman was introduced to our department with asymptomatic gross hematuria. Cystoscopy revealed a gently raised nodule at the right lateral wall. Histopathological findings of this lesion revealed extensive amorphous eosinophilic deposits that stained positive with Congo red and Dylon. The patient was diagnosed with primary localized amyloidosis of the urinary bladder. To treat residual amyloidosis of the bladder, we performed occlusive dressing therapy using dimethyl sulfoxide. After treatment, cystoscopy and magnetic resonance imaging showed no relapse of the mass-like lesion of the bladder wall.
  
  
  CONCLUSIONS
  Occlusive dressing therapy using dimethyl sulfoxide is efficacious and tolerable for amyloidosis of the urinary bladder. The maneuver of occlusive dressing therapy was simpler and easier than that of intravesical instillation, and occlusive dressing therapy was advantageous in that the patient could perform the therapy herself every day. However, invasive surgical management including cystectomy should be considered if conservative management is inefficacious.
authors.affiliation: Department of Urology, JA Onomichi General Hospital, 1-10-23 Hirahara, Onomichi, Hiroshima, 722-0018, Japan. uroltateki@yahoo.co.jp.
authors.forename: Tateki
authors.initials: T
authors.lastname: Yoshino
authors.forename: Shinya
authors.initials: S
authors.lastname: Ohara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Moriyama
references.citation: Amyloid. 2006 Sep;13(3):135-42
references.pmid: 17062379
references.citation: Urology. 2006 May;67(5):904-9
references.pmid: 16635518
references.citation: Nihon Hinyokika Gakkai Zasshi. 2005 Nov;96(7):705-8
references.pmid: 16363658
references.citation: J Urol. 2002 Sep;168(3):1018-20
references.pmid: 12187212
references.citation: Hinyokika Kiyo. 2011 Aug;57(8):439-43
references.pmid: 21894081
references.citation: J Urol. 2010 Jun;183(6):2388-9
references.pmid: 20403624
references.citation: Hinyokika Kiyo. 2000 Jun;46(6):421-4
references.pmid: 10934614
references.citation: BMJ Case Rep. 2011 Jul 20;2011:
references.pmid: 22689606
references.citation: Nihon Rinsho. 1979 Sep 10;37(9):3278-84
references.pmid: 522272
references.citation: Urology. 1980 Feb;15(2):174-80
references.pmid: 6986707
references.citation: Mayo Clin Proc. 2000 Dec;75(12):1264-8
references.pmid: 11126834