Inverted papilloma of the prostatic urethra: a report of two cases

Two men with inverted papilloma of the prostatic urethra are reported. Case 1 was a 67-year-old man with complaints of gross hematuria and urinary retention. Urethroscopy revealed a smooth-surface tumor with a stalk at the prostatic urethra. Case 2 was a 76-year-old man with complaints of gross hematuria and urinary retention. In these cases, the tumors were resected transurethrally and were consistent with inverted papilloma histopathologically.     

Inverted papilloma of the urinary bladder: three case reports

We report three cases of inverted papilloma of the urinary bladder. Case 1. A 19-year-old male complained of pollakisuria, gross hematuria and micturition pain. Cystoscopy revealed a smooth-surfaced tumor on a stalk at the bladder neck. The tumor was removed transurethrally. Histological diagnosis was inverted papilloma. As a safe guard, intravesical chemotherapy (Adriamycin) was performed, since pathological findings revealed a small region with mild atypical cells in the removed tumor. The patients has been subsequently followed up for ten years without any evidence of recurrence. Case 2. A 63-year-old male was admitted to our hospital because of a bladder tumor incidentally found by abdominal ultrasonography. The tumor was removed transurethrally. Histological diagnosis was inverted papilloma. The patient has been subsequently followed up for one year without any evidence of recurrence. Case 3. A 71-year-old male complained of pollakisuria, loss of urinary force and interruption of the urinary stream. A smooth-surfaced tumor found at the bladder neck was removed transurethrally. Histological diagnosis was inverted papilloma. Three months later, cystoscopy revealed two sessile papillary tumors on the left lateral wall of the urinary bladder. Pathological diagnosis was transitional cell carcinoma (G2, pTa). Although the inverted papilloma is a benign tumor, there is a possibility of recurrence or development of transitional cell carcinoma. Therefore, we advocate periodical follow-up examinations.     

Inverted papilloma of the ureter with non-functional kidney: a case report

Inverted papilloma of the ureter is a rare lesion. We report a case of ureteral inverted papilloma with a non-functional kidney. A 66-year-old male was admitted to our hospital for investigation of left hydronephrosis. Left ureter tumor was diagnosed on X-ray (retrograde pyelogram, CT) and total nephro-ureterectomy was performed. The pathological diagnosis was ureteral inverted papilloma. Diagnosis and treatment of ureteral inverted papilloma are discussed.     

Inverted papilloma of the urinary bladder in a girl

We report a case of inverted papilloma of the urinary bladder in a 10-year-old girl. She was referred to us with intermittent asymptomatic gross hematuria. A polypoid, pedunculated mass, which had a thin and long stalk, approximately 6 x 20 mm in diameter, was observed by cystscopic examination at the right paratrigone. The lesion was resected endoscopically. Histological findings were compatible with the trabecular type of inverted papilloma. There have been only 3 cases reported of inverted papilloma in children, and no report has previously been published concerning a girl. Since the biological potential of pediatric inverted papilloma remains unclear, we believe that our patient should undergo periodic and detailed urological examinations.     

Intracranial extension of inverted papilloma: An unusual and potentially fatal complication

BACKGROUND: The purpose of this article is to define the outcome of intracranial extension of inverted papilloma and outline a rationale for management of this rare clinical presentation. METHODS: A review of patients with intracranial extension of inverted papilloma reported in the literature (18 patients), or treated in our institution (3 patients ) was performed. The data of these 21 patients were consolidated with regard to clinical presentation, treatment, and outcome. Nine patients, including 1 of our cases, had coexisting squamous cell carcinoma and therefore were excluded from the analysis. Twelve patients with "pure" inverted papilloma formed the basis of this study. RESULTS: The majority of patients (83%) with intracranial inverted papilloma had recurrent disease. Patients with extradural disease had a survival rate of 86% with an average follow-up of 4.4 years. Eighty-six percent of these survivors were treated with craniofacial resection. In contrast, 75% of patients with intradural inverted papilloma were dead of disease with an average follow-up of 9.3 months regardless of the treatment modality. CONCLUSIONS: Intracranial extension of inverted papilloma is mostly associated with recurrent disease. Intracranial extradural inverted papilloma can be effectively controlled with craniofacial resection. Intracranial intradural involvement of inverted papilloma has a poor prognosis regardless of treatment. Aggressive treatment of intranasal inverted papilloma may be the most important factor in preventing intracranial presentation.     

Inverted papilloma of the ureter

Two cases of ureteral inverted papilloma are reported. Case 1: A 48-year-old male had asymptomatic gross hematuria and filling defect of left middle ureter on intravenous pyelography. Segmental resection of ureter was performed. The specimen was a 1 cm polypoid lesion with histologic features resembling "multifocal bud-like proliferation", which was reported as the initial stage of the inverted urothelial tumor by Kunze et al. Case 2: A 64-year-old female with asymptomatic gross hematuria and complete obstruction of left middle ureter on ante- and retrograde pyelograms. Total nephroureterectomy was performed. A 4 cm lobulated and pedunculated lesion with histologic features of typical inverted urothelial papilloma was resected. Twenty-one cases of ureteral inverted papilloma in the literature, including our cases, are analyzed.     

A case of inverted papilloma with subsequent heterotopical recurrence of transitional cell carcinoma

A case of inverted papilloma with subsequent heterotopical recurrence of inverted type transitional cell carcinoma is reported. A 24-year-old man had a medical examination of our hospital with chief complaint of asymptomatic macroscopic hematuria on October 23, 1982. Cystoscopy revealed a smooth surfaced and finger-tip sized tumor at the bladder neck. Because of the large bulk and the location of the tumor, the tumor was resected through cystotomy. After histological examination, the tumor was diagnosed as inverted papilloma. Cystoscopy was repeated every 3-6 months. The tumor recurred 4 times heterotopically, 19, 35, 43 and 53 months after the initial surgery. The pathological examinations of these tumor specimens showed transitional carcinoma mostly of inverted growth. Most of the urologists and pathologists believe inverted papilloma to be a benign neoplasm, but several reports and this case suggest the possibility of recurrence and malignant transformation of inverted papilloma.     

A case of inverted papilloma of the prostatic urethra

A 59-year-old male with a complaint of gross hematuria was found to have a pedunculated and non-papillary tumor on the prostatic urethra. The tumor was resected transurethrally. The pathological finding was inverted papilloma. Although the majority of the cases of inverted papilloma have been found in the bladder, we reported the 32nd case located on the prostatic urethra in Japan.     

Inverted papilloma of the renal pelvis]

A 60-year-old man with inverted papilloma of right renal pelvis is presented. On visit to hospital for benign prostatic hyperplasia with prostatic stone, he was found to have microscopic hematuria and intravenous pyelography and retrograde pyelography demonstrated a filling defect with papillary contour. We diagnosed a right renal pelvic tumor, which showed to be low grade because of negative cytology. Therefore, we performed tumor resection with renal preservation. Pathological diagnosis was inverted papilloma. From the Japanese and foreign literature, 16 cases of renal pelvic inverted papilloma were collected. They were reviewed clinically and pathologically, and the therapy was discussed.     

Inverted papilloma of the upper urinary tract

Four cases of inverted papilloma in the upper urinary tract are reported-three were located in the ureter and one in the renal pelvis. Clinical and pathological findings are described. In two cases the patients had a history of transitional cell carcinoma; while in one case, inverted papilloma was found in the same lesion as transitional cell carcinoma. The question of malignant transformation of inverted papilloma is discussed. It is concluded that inverted papilloma is a benign tumor with a very low frequency of recurrence, but regular follow-up is advised.     

A case of inverted papilloma of the ureter with malignant findings

A 70-year-old female with inverted papilloma of the ureter is presented. She was hospitalized because of asymptomatic macrohematuria. Excretory urography and retrograde pyelography demonstrated a filling defect with smooth contour at the mid-portion of the right ureter. Abdominal computer tomographic (CT) scan showed mass lesion (CT number 41) at the same portion as the filling defect. She was diagnosed as having an ureteral tumor and right nephroureterectomy was performed. The gross specimen contained a 24 X 12 mm, polypoid, pedunculated and smooth-surfaced tumor. Pathological diagnosis was inverted papilloma. However, microscopic examination revealed a malignant finding corresponding to transitional cell carcinoma grade 1. From the Japanese and foreign literature, 25 cases of ureteral inverted papilloma were collected and are reviewed. Clinical and pathological features are discussed.     

Inverted papilloma of the renal pelvis associated with renal cell carcinoma: a case report.

Twenty-one cases of inverted papilloma of the renal pelvis have been described in the literature. A 71-year-old man was admitted to our hospital to examine a right renal mass. We diagnosed a right renal tumor on the basis of the findings from excretory urogram (IVP), computerized tomography (CT) and magnetic resonance imaging (MRI). Surgical material revealed an inverted papilloma in the renal pelvis. We report on the first case of an invested papilloma of the renal pelvis associated with renal cell carcinoma.     

A case report of inverted papilloma of the posterior urethra

Sixty-seven cases of inverted papilloma have been reported in many anatomical sites of urinary tract but only 9 cases involving the posterior urethra have been described in Japan. We report the 10th case of inverted papilloma of the posterior urethra in a 27-year-old male who complained of macroscopic hematuria. The lesion was diagnosed cystoscopically and treated by transurethral resection.     

Inverted papilloma of the renal pelvis: report of a case

Inverted papilloma of the upper urinary tract is a rare lesion. To our knowledge, we report here the 32nd case of inverted papilloma of the renal pelvis. A 50-year-old man presented with asymptomatic gross hematria. Excretory urography showed a filling defect in the left upper calyx. Computerized tomography showed a poorly enhanced low-density area within the renal pelvis. Since radiographic findings suggested a renal pelvic tumor, the patient underwent total nephroureterectomy. Unexpectedly, a 3 x 2.5 cm polypoid tumor of the renal pelvis was consistent with inverted papilloma. Since this benign lesion is extremely rare within the upper tract and its radiographic characteristics closely resemble those of urothelial carcinoma, the preoperative diagnosis of inverted papilloma of the upper tract cannot be conclusively established even by modern imaging techniques. Therefore treatment consistent with that for urothelial carcinoma should be applied in this disease entity.     

膀胱良性上皮性肿瘤27例报告及文献复习

目的：探讨膀胱良性上皮性肿瘤的诊断与治疗方法。方法：回顾性分析27例膀胱良性上皮性肿瘤的诊断与治疗方法。术前经尿脱落细胞学检查、B超、CT、尿路造影、膀胱镜检查加活检诊断为乳头状瘤10例．内翻性乳头状瘤9例，分化Ⅰ级乳头状癌8例。27例均行单纯经尿道膀胱肿瘤切除术(TURBT)。结果：术后经病理检查明确诊断为乳头状瘤13例(4例伴非典型性增生)．内翻性乳头状瘤14例(4例伴非典型性增生)。随访9个月～2年，乳头状瘤、内翻性乳头状瘤患者各2例复发．复发率分别为15.4％和14.3％。复发病例均伴有非典型性增生，无恶性进展。复发者经二次TURBT后随访至今未见再次复发。结论：膀胱良性上皮性肿瘤的术前诊断主要依靠膀胱镜检查加活检，而确诊有赖于术后病理检查。TURBT是其首选治疗方法。对于不伴非典型性增生的乳头状瘤和内翻性乳头状瘤患者．术后可不作腔内灌药；而对于伴非典型性增生的患者．术后要常规腔内灌注抗癌药，以降低复发和防止恶变的可能。     

Inverted papilloma of the urinary bladder: A case evaluated for malignant potential

We report a case of inverted papilloma in the urinary bladder with special reference to its malignant potential. A 77-year-old male patient complaining of microhaematuria was subjected to cystoscopic examination, which showed a non-papillary pedunculated tumour at the postero-lateral wall, and was treated with transurethral resection. The histological findings of the specimen were compatible with inverted papilloma of the urinary bladder, except for the presence of low grade dysplastic changes in the tumour nuclei. We revealed the malignant potential of this tumour, analyzing and evaluating nuclear DNA content, proliferating cell nuclear antigen (PCNA) as well as p53 expression.     

鼻内镜下上颌窦（扩大）内壁切除术在鼻内翻性乳头状瘤手术中的应用

目的探讨鼻内镜下上颌窦（扩大）内壁切除术在鼻内翻性乳头状瘤手术中的应用价值。方法回顾分析2002年1月～2006年12月采用鼻内镜下上颌窦（扩大）内壁切除术治疗鼻内翻性乳头状瘤10例的临床资料。结果10例均在鼻内镜下完全切除。10例随访12～72个月,平均30个月;术后仅1例术后1年后复发;10例均无溢泪发生。结论鼻内镜下上颌窦（扩大）内壁切除术在鼻内翻性乳头状瘤手术中的应用是可行的,基本接近鼻侧切开的手术范围;最大优点是可避免面部瘢痕、创伤小、手术视野清晰、能够准确完整地切除肿瘤、术后复发率低。     

Inverted papilloma arising in a juvenile

A 15-year-old man presented with painless, gross hematuria. Excretory pyelography showed a filling defect in the bladder and ultrasonography revealed a solitary bladder tumor. Cystoscopy showed a solitary, papillary tumor on the bladder neck. Transurethral resection was then performed and histological examination showed an inverted papilloma. In addition, the expression of proliferative cellular nuclear antigen and p53 in the surgical specimen were 37.1 and 0%, respectively. Since an inverted papilloma arising during the first two decades of life is quite rare, we herein report the above case and review previous reports.     

Inverted papilloma of renal pelvis associated with contralateral ureteral malignancy and bladder recurrence

We report a case of an inverted papilloma of the renal pelvis diagnosed at the same time as transitional cell carcinoma of the contralateral ureter. The diagnostic studies and surgical management are presented. Recurrence of an inverted papilloma in the bladder 1 year after treatment was confirmed histologically. Recurrence of this lesion and the association with urothelial malignancy suggest the need for close followup of patients with an inverted papilloma.