Ureteral Fibroepithelial Polyp Protruding Into the Bladder Which Mimics a Bladder Tumour

A Case Report and Literature Review

Jae Yoon Kim; Ji Hyeong Yu; Luck Hee Sung; Hyun Jung Kim; Dae Yeon Cho

Disclosures

Transl Androl Urol. 2022;11(5):720-726. 

In This Article

Abstract and Introduction

Abstract

Background: Ureteral fibroepithelial polyp is a rare benign lesion of the urinary tract. The incidence of the disease has been increasing recently; however, the aetiology of this tumour remains unclear. Early diagnosis and management are important, and endoscopic treatment is increasingly being preferred worldwide.

Case Description: We report the case of a 49-year-old patient who presented with urinary frequency, intermittent haematuria, and an echogenic bladder mass found on pelvic sonography. Cystoscopy revealed an irregularly shaped large bladder mass, suggesting a benign or malignant bladder tumour. On subsequent examination, intravenous urography (IVU) and computed tomography showed a large lobulated contour filling defect in the bladder, measuring approximately 4 cm, with a suspected finding of a long stalk in the left distal ureter. Ureteroscopy revealed a long and narrow pedunculated tumour in the left distal ureter protruding into the bladder cavity through the ureteral orifice. On endoscopic excision, the attached stalk of the polyp into the ureter was cut using holmium:yttrium aluminium garnet (YAG) laser. The polyp was completely excised and extracted in its entirety, including the section protruding into the bladder. Histopathological findings confirmed the diagnosis of a fibroepithelial polyp. There was no sign of complication or recurrence on computed tomography performed after 12 months.

Conclusions: The ureteral fibroepithelial polyp protruding into the bladder mimicked a bladder tumour and was successfully treated by endoscopic resection, with no complications or recurrence. Endoscopic treatment is an effective and safe method to treat fibroepithelial polyps of the ureter.

Introduction

A ureteral fibroepithelial polyp is a rare benign tumour that develops in the urinary tract.[1,2] The aetiology of this tumour remains unclear. Patients often present with haematuria and flank pain due to obstructive hydronephrosis and urinary tract infection.[2,3] Few cases and small series have been reported in the literature. Therefore, the choice of treatment remains unclear. Following the introduction of endoscopy for its diagnosis and treatment in recent times, several authors have reported favourable results using the endoscopic approach without complication or recurrence. Currently, endoscopic treatment has been increasing worldwide.[2,4,5] Early diagnosis and treatment are necessary to prevent aggravation of the disease and possible complications. We present the following case in accordance with the CARE reporting checklist (available at https://tau.amegroups.com/article/view/10.21037/tau-21-1041/rc).

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