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Presented by George Netto, M.D. and prepared by Aatur Singhi, M.D., Ph.D.
Case 4: A 65 year old male presented with hematuria.
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1. Question
Week 426: Case 4
A 65 year old male presented with hematuria. He was found to have a 1 cm firm polypoid bladder mass on cystectomyimages/1Alex/03012010case4image1.jpg
images/1Alex/03012010case4image2.jpg
images/1Alex/03012010case4image3.jpgCorrect
Answer: Benign inverted urothelial papilloma
Histology: none provided
Discussion: Inverted urothelial papilloma (IP) is an uncommon urothelial neoplasm. In a recent large cohort of 75 IPs, patients ranged in age from 26 to 85 years (mean, 60 years). 28/46 patients had a history of smoking. The majority (67) of IP lesions were located in the urinary bladder and arose from the trigone or near the bladder neck. Common presenting complaints included hematuria, dysuria, and irritative voiding symptoms. Only 1 IP patient demonstrated recurrence. All other patients were free of tumor recurrence or progression during a mean follow-up of 68 months (up to 240 months F/U). When diagnosed according to strictly defined morphologic criteria, IP is a benign urothelial neoplasm adequately treated by complete transurethral resection. Strict patient surveillance seems unnecessary in IP cases.
Reference(s):
– Sung MT, Maclennan GT, Lopez-Beltran A, Montironi R, Cheng L. Natural history of urothelial inverted papilloma. Cancer. 2006 Dec 1;107(11):2622-7.Incorrect
Answer: Benign inverted urothelial papilloma
Histology: none provided
Discussion: Inverted urothelial papilloma (IP) is an uncommon urothelial neoplasm. In a recent large cohort of 75 IPs, patients ranged in age from 26 to 85 years (mean, 60 years). 28/46 patients had a history of smoking. The majority (67) of IP lesions were located in the urinary bladder and arose from the trigone or near the bladder neck. Common presenting complaints included hematuria, dysuria, and irritative voiding symptoms. Only 1 IP patient demonstrated recurrence. All other patients were free of tumor recurrence or progression during a mean follow-up of 68 months (up to 240 months F/U). When diagnosed according to strictly defined morphologic criteria, IP is a benign urothelial neoplasm adequately treated by complete transurethral resection. Strict patient surveillance seems unnecessary in IP cases.
Reference(s):
– Sung MT, Maclennan GT, Lopez-Beltran A, Montironi R, Cheng L. Natural history of urothelial inverted papilloma. Cancer. 2006 Dec 1;107(11):2622-7.
