Upper urinary tract inverted papillomas: Report of 10 cases

Abstract

The aim of the study was to review the clinical features and treatments of 10 (9 males and 1 female; age range, 61-73 years; median age, 67 years) upper urinary tract inverted papilloma (IP) cases between 1995 and 2010. The clinical syndromes, diagnostic procedures, treatments and results of the follow-up were evaluated. The results showed that the site of tumor development was the ureter in 6 cases and the renal pelvis in 4 cases. It was also identified that 7 tumors developed on the left side and 3 developed on the right side of the ureter and renal pelvis, respectively. A nephroureterectomy was performed in the first 6 cases, while a partial ureterectomy was performed in 3 cases and a local resection was performed endoscopically in 1 case. All but 2 tumors were solitary, ranging from 5 to 30 mm in diameter. Occurrence in association with transitional cell carcinoma was identified in one case. All 10 patients were subject to follow-up (range, 19-120 months; median, 59 months), during which no recurrence was found. Local excision is considered as adequate treatment when upper urinary tract IP is diagnosed according to strictly defined criteria.

Figure 1

(A) Histological appearance of an IP demonstrating intact surface lining urothelium and underlying thin anastomosing urothelial islands (H&E staining; magnification, ×50). (B) Anastomosing cords of bland transitional cells with specific small gland-like areas (H&E staining; magnification, ×200). IP, inverted papilloma.