Urothelial papilloma

Urothelial papilloma is a rare, benign tumor that originates in the urinary bladder's urothelial cells. It is characterized by a fibrovascular core covered by normal-appearing urothelial cells.

Epidemiology

Urothelial papilloma is a rare condition, accounting for less than 1% of all urinary bladder tumors. It is more common in males than in females and typically occurs in the fifth to sixth decade of life.

Pathology

Urothelial papilloma is characterized by a fibrovascular core covered by normal-appearing urothelial cells. The urothelial cells are uniform in size and shape, with no significant nuclear atypia or mitotic activity. The underlying stroma may show mild inflammation.

Clinical Presentation

Patients with urothelial papilloma typically present with hematuria, which is often microscopic. Other symptoms may include urinary frequency, urgency, and dysuria. However, many patients are asymptomatic, and the tumor is discovered incidentally during imaging studies for other conditions.

Diagnosis

The diagnosis of urothelial papilloma is made by cystoscopy and biopsy. The tumor appears as a small, solitary, papillary lesion on cystoscopy. Histologically, the tumor is characterized by a fibrovascular core covered by normal-appearing urothelial cells.

Treatment

The treatment of choice for urothelial papilloma is transurethral resection. This procedure involves the removal of the tumor using a resectoscope inserted through the urethra. Following resection, patients are typically followed with periodic cystoscopy to monitor for recurrence.

Prognosis

The prognosis for patients with urothelial papilloma is generally excellent. The tumor is benign and does not invade the bladder wall or metastasize to other sites. However, there is a risk of recurrence, and some patients may develop urothelial carcinoma in situ or invasive urothelial carcinoma.