2012, Number 3
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ABSTRACTIntroduction: urothelial papillomas of the bladder are uncommon benign tumors predominantly occurring in male children and young adults.
Objective: present a new case of urothelial papilloma of the bladder as well as aspects of its diagnosis and treatment.
Clinical case: male patient aged 20 presenting at urology consultation with macroscopic hematuria of three days' evolution. Interrogation revealed that the latter was terminal, monosymptomatic and was not accompanied by clots. The physical examination was normal. Abdominal ultrasonography revealed the presence of an echogenic tumoral lesion of irregular contour projecting from the bladder bottom toward the right side. Cystoscopy confirmed the presence of the tumor described above. Transurethral resection of the lesion was performed without any complications. The anatomo-pathological report identifies the surgical piece as an urothelial papilloma. The patient's evolution has been satisfactory. In semiannual and annual checkups he has been found to be asymptomatic. Ultrasonographic and cystoscopic examination has shown no evidence of tumor recurrence.
Conclusions: urothelial papillomas of the bladder rarely cause hematuria. Transurethral resection is a safe, effective treatment option. It is necessary to establish a differential histopathological diagnosis with respect to other non-invasive neoplastic urothelial lesions, given the particular recurrence features, progression and management of these tumors.
Montironi R, Mazzucchelli R, Scarpelli M, López Beltrán A, Cheng L. Morphological diagnosis of urothelial neoplasms. J Clin Pathol. 2008;61:3-10.
Magi-Galluzi C, Epstein JI. Urothelial papilloma of the bladder: A review of 34 de novo cases. Am J Surg Pathol. 2004;28(12):1615-20.
Eble JN, Sauter G, Epstein JI, Sesterhenn IA, editors. Pathology and genetics of tumours of the urinary system and male genital organs. WHO. International Agency for Research on Cancer. Lyon: IARC Press;2004. p. 90.
Álvarez Kindelán J, Campos Hernández JP, López Beltrán A, Requena Tapia MJ. Clasificación de la OMS para los tumores vesicales: resumen y comentarios. Actas Urol Esp. 2007;31(9):978-88.
Grignon DJ. The current classification of urothelial neoplasms. Mod Pathol. 2009;22:60- 9.
Mc Kenney JK, Amin MB, Young RH. Urothelial (Transitional Cell) papilloma of the urinary bladder: A clinicopathological study of 26 cases. Mod Pathol. 2003;16(7):623-9.
Martínez Ballesteros C, Carballido Rodríguez J. Tumores vesicales superficiales. En: Castiñeiras Fernández J. Libro del Residente de Urología. Asociación Española de Urología. Madrid: Gráficas Marte, SL;2007. p. 494.