Edit concept Question Editor Create issue ticket

Papilloma of the Bladder

Papilloma of the bladder is defined as a benign lesion of the urinary tract that presents in older adults, with a strong predilection toward male gender. In rare cases, however, transformation into a malignant variant has been observed. Principal symptoms include hematuria, dysuria, and other voiding-related complaints. To make the diagnosis, it is necessary to conduct a detailed clinical assessment followed by invasive imaging studies of the urinary bladder (cystoscopy) and subsequent histopathological examination.


Presentation

Patients of all ages can develop a papilloma of the bladder, but the majority of patients are older adults in their 50s and 60s [1] [2] [3] [4]. There is a marked predominance of male patients, with a male-to-female ratio reportedly of 7:1 in certain studies [2] [3] [5]. The most common symptom identified in patients with a papilloma of the bladder is macroscopic hematuria [4] [6], whereas dysuria and obstructive/irritative symptoms are also frequently encountered [3] [4]. Suprapubic pain, urinary retention, and pyuria were identified in rare cases and isolated studies observed that patients infrequently report more than one symptom [6]. An asymptomatic course occurs in a minority of patients and the diagnosis can be made incidentally [3]. The etiology and pathogenesis of papilloma of the bladder remain undisclosed, but cigarette smoking has been postulated as a possible risk factor [3] [4].

Aspiration
  • Presents two brand-new chapters covering urinary cytology and fine needle aspiration to keep you up to date. Covers newly described entities and application of ancillary study for precise diagnosis.[books.google.de]
Macroscopic Hematuria
  • The most common symptom identified in patients with a papilloma of the bladder is macroscopic hematuria, whereas dysuria and obstructive/irritative symptoms are also frequently encountered.[symptoma.com]
  • 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.[new.medigraphic.com]

Workup

The diagnosis of papilloma of the bladder may be difficult to make solely on clinical findings, but initial suspicion toward a lower urinary tract pathology can be raised only through a patient history and a physical examination. Physicians should determine the characteristics of symptoms, their progression, and severity, and if sufficient evidence is raised, imaging studies should be employed. Because papillomas grow in an endophytic fashion (the most superficial layer of the transitional urinary bladder epithelium is intact), urine cytology analysis is of little benefit [4], which is why cystoscopy is the procedure of choice. A typical finding is a pedunculated solitary mass that ranges from a few millimeters to several

A detailed medical history will reveal dysuric symptoms as well as hematuria and pain in the suprapubic region. Because papillomas grow in an endophytic fashion (the most superficial layer of the transitional urinary bladder epithelium is intact), urine cytology analysis is of little benefit [4], which is why cystoscopy is the procedure of choice. A typical finding is a pedunculated solitary mass that ranges from a few millimeters to several centimeters in diameter, mainly located in the trigone, the neck, or the lateral walls of the bladder [2] [4] [6]. In very rare cases, multiple papillomas can be identified [2]. To confirm a papilloma of the bladder and exclude malignant disease, a biopsy with a subsequent histopathological examination is crucial. A normal urothelium without dysplastic changes and mitotic figures, formation of epithelial nests of different sizes containing adenoid structures from the epithelium to the lamina propria, and the "umbrella"-shaped appearance of the urothelial cells are some of the key findings that distinguish papilloma of the bladder from other potentially malignant lesions [1] [2] [5] [6].

Treatment

  • Bladder cancer gene therapy 71 1 711 Treatment of nonTCC adenocarcinomasarcoma 723 Treatment of squamous cell carcinoma 729 Pediatric bladder tumours 735 Ancillary 749 Support groups 755 Index 763 Urheberrecht[books.google.de]
  • Do not blindly believe folk treatments. Folk remedies can only be part of the comprehensive treatment for medicaments prescribed by the doctor.[medicalj-center.info]
  • Transurethral resection is a safe, effective treatment option.[new.medigraphic.com]
  • We analyze their clinical presentations, histological findings and the outcome of treatments. RESULTS: Four patients presented with hematuria, and four with obstructive symptoms.[ncbi.nlm.nih.gov]
  • These observations stimulated my interest in this method of treatment and, as a consequence, smaller pedunculated tumors of the bladder have been excised intravesically in this fashion in twenty-six instances during the last three years.[mdedge.com]

Prognosis

  • The aim of this systematic review and analysis of the literature since 1990 to date is to contribute to unresolved issues regarding the biological behavior and prognosis of these neoplasms to establish some key points in the clinical and surgical management[ncbi.nlm.nih.gov]
  • Prognosis and Predictive Factors Urothelial papilloma is a benign tumor that may recur but does not progress. Rare cases of progression have been described in association with immunosuppressive therapy. [5][emedicine.medscape.com]
  • Differential diagnosis and prognosis of nonmuscle invasive tumor entities of urinary bladder epithelium are often challenging.[pubfacts.com]
  • Prognosis  Non–muscle invasive bladder cancer has a good prognosis, with 5-year survival rates of 82-100%.[slideshare.net]
  • Patients with metastatic disease, in contrast, have a poor prognosis (5-year survival of 6%) 4 .[radiopaedia.org]

Etiology

  • The etiology and pathogenesis of papilloma of the bladder remain undisclosed, but cigarette smoking has been postulated as a possible risk factor.[symptoma.com]
  • Urothelial papilloma tends to occur in younger patients and may be seen in children. [1] Etiology The risk factors for urothelial papilloma are similar to those of other urothelial neoplasms.[emedicine.medscape.com]
  • Read More Etiological role of human papillomavirus infection for inverted papilloma of the bladder.[pubfacts.com]
  • Cancer of bladder 1) Incidence and prevalence. 2) Etiology/ Risk factors. 3) Pathology. 4) Clinical features. 5) Investigation and diagnosis. 6) Staging and Management. 7) Prognosis 18.[slideshare.net]
  • […] exophytic neoplasm composed of a delicate fibrovascular core covered by normal-appearing urothelium (1,2). a low incidence – representing 1-4% of bladder tumours. cigarette smoking and occupational exposure to aromatic amines are the most important etiology[wsoonli15.wordpress.com]

Epidemiology

  • Pathological and epidemiological characteristics of this distinct bladder lesion are outlined, comparison with transitional cell papilloma is investigated, and recommended therapy and follow-up are offered.[ncbi.nlm.nih.gov]
  • Definition Urothelial papilloma is a benign exophytic neoplasm composed of a delicate fibrovascular core covered by normal-appearing urothelium. [1, 2] Epidemiology Urothelial papilloma has a low incidence; it represents 1-4% of bladder tumors.[emedicine.medscape.com]
  • Epidemiology The risk factors for squamous papilloma are similar to those for other urothelial neoplasms; cigarette smoking and occupational exposure to aromatic amines are among the most important.[emedicine.medscape.com]
  • Definition / general Discrete papillary growth with a central fibrovascular core lined by urothelium of normal thickness and cytology Epidemiology Uncommon if use restrictive diagnostic criteria (less than 1% of bladder tumors) Tends to occur in younger[pathologyoutlines.com]
  • […] transitional cell carcinoma of the urinary tract TCCs in other locations: transitional cell carcinoma of the renal pelvis transitional cell carcinoma of the ureter other histologies: squamous cell carcinoma of the bladder adenocarcinoma of the bladder Epidemiology[radiopaedia.org]
Sex distribution
Age distribution

Pathophysiology

  • However, the occurrence of upper urinary tract localization is not surprising when considering how the urothelial-lined tissue behaves as a single pathophysiological unit.[spandidos-publications.com]

Prevention

  • If was discovered papilloma shown mandatory treatment to prevent transition to malignancy. Treatment methods are determined by the degree of proliferation of papillomas in the urinary bladder and can be assigned only by a physician.[medicalj-center.info]

References

Article

  1. McKenney JK, Amin MB, Young RH. Urothelial (transitional cell) papilloma of the urinary bladder: a clinicopathologic study of 26 cases. Mod Pathol. 2003;16(7):623-629.
  2. Picozzi S, Casellato S, Bozzini G, et al. Inverted papilloma of the bladder: a review and an analysis of the recent literature of 365 patients. Urol Oncol. 2013;31(8):1584-1590.
  3. Brown AL, Cohen RJ. Inverted papilloma of the urinary tract. BJU Int. 2011;107 Suppl 3:24-26.
  4. Sung M, Maclennan GT, Lopez-Beltran A, Montironi R, Cheng L. Natural history of urothelial inverted papilloma Cancer. 2006;107(11):2622-2627.
  5. Magi-Galluzzi C, Epstein JI. Urothelial papilloma of the bladder: a review of 34 de novo cases. Am J Surg Pathol. 2004;28(12):1615-1620.
  6. Guo A, Liu A, Teng X. The pathology of urinary bladder lesions with an inverted growth pattern. Chin J Cancer Res. 2016;28(1):107-121.

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!
Last updated: 2018-06-21 22:15