Localised retroperitoneal amyloidosis mimicking retroperitoneal fibrosis: a rare cause of obstructive uropathy

Banerji JS, Gopalakrishnan G, Sriram K, Manipadam MT
Correspondence: Dr Banerji John Samuel, johnsbanerji2002@yahoo.co.in

ABSTRACT
Primary localised amyloidosis involving the retroperitoneum is a rare disease. We report a 71-year-old diabetic man who presented with generalised fatigue, malaise and elevated serum creatinine. Investigations confirmed obstructive uropathy secondary to a retroperitoneal mass behind the urinary bladder, causing extrinsic compression of both the ureters, resulting in bilateral hydroureteronephrosis. Following initial bilateral percutaneous nephrostomies to stabilise renal function, a computed tomography-guided biopsy of the pelvic lesion which was done, was suggestive of amyloidosis. We present this case due to the rarity of localised retroperitoneal amyloidosis as a cause of obstructive uropathy.

Keywords: amyloidosis, localised retroperitoneal amyloidosis, obstructive uropathy, retroperitoneum, retrovesical amyloid deposition
Singapore Med J 2009; 50(9): e332-e335