Massive hematuria and perforation in a case of amyloidosis of the bladder: case report and review of the literature.

To our knowledge this is the first time that perforation of the bladder has been reported in a case of amyloidosis. The perforation was caused by massive hematuria. Based on repeated cystoscopic observations we believe that this alteration of the bladder wall is progressive and caused by the damaging effect of a continuing growing clot on poorly vascularized tissues. A review of 5 other cases of secondary amyloidosis complicated by massive hematuria indicates that hemorrhage occurs in advanced stages of the disease, has a gloomy prognosis and may precipitate the final outcome.