Mysterious visitor in the bladder: Ureteral fibroepithelial polyp

Abstract

We present a unique case with a ureteral fibroepithelial tumor originating from the ureter, which could be confused with a bladder tumor on ultrasound examination due to its movement in and out of the bladder. METHODS: In cystoscopy, a papillary tumor lesion emerging from the right ureteral orifice was seen. After scanning the other quadrants, however, the tumor was not observed at the right ureteral orifice. It was then protruded back into the bladder. The tumor was seen several times to protrude into the bladder and return to the ureter, possibly due to ureteral peristalsis. Then, a semi-rigid ureteroscope was introduced through the right ureteric orifice, and the tumor was excised in one piece using Holmium laser fiber with 365μm of diameter. The size of the removed tumor was approximately 8 cm long. A double-j stent of 4.8 Fr was placed in the ureter. RESULTS: The patient was discharged on the first day without complications. The fibroepithelial polyps of the ureter, which consist of the stroma of mesoderm origin, covered with histologically normal or hyperplastic urothelial epithelial cells, are extremely rare tumors. It is important to distinguish these polyps from urothelial cancers, since these two entities are different in treatment and prognosis, although similar in symptoms and imaging procedures. CONCLUSIONS: Minimally invasive treatment techniques can be safely applied in the treatment of such exceedingly rare tumors.

Presentamos un caso único de tumor fibroepitelial ureteral originado en el uréter que se puede confundir con un tumor vesical por ecografía debido al movimiento dentro y fuera de la vejiga. MÉTODOS: En la cistoscopia, se vió una lesión tumoral papilar saliendo del meato ureteral. Después de mirar el resto de zona de la vejiga, dejamos de ver el tumor en el meato ureteral derecho. Una vez más, protuía después, en la vejiga. Se realizó una ureteroscopia semirrígida y se quitó el tumor en una pieza con laser holmium de 365. El tumor tenía una longitud de 8 cm. Se colocó un catéter doble J 4.8 Fr en el uréter. RESULTADOS: El paciente fue dado de alta en el primer día postoperatorio sin complicaciones. El pólipo fibroepitelial del uréter consiste en estroma del mesodermo cubierto de histológica normal o hiperplásica. Estos tumores son extremadamente raros. Es importante diferenciarlos de los tumores uroteliales ya que el tratamiento y pronóstico es diferente, aunque los síntomas y las técnicas de imagen son parecidas.