Fibromyxoid Nephrogenic Adenoma in the Ureter

Dropkin, Benjamin M.; Giannico, Giovanna A.; Reisz, Peter; Penson, David F.; Hsi, Ryan S.

doi:10.1089/cren.2018.0037

Cited by 8 publications

(10 citation statements)

References 3 publications

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“…There have been 3 additional cases of this rare variant reported in 2 case reports and 3 additional cases included in our recently published paper on the collision of urothelial cancer with nephrogenic adenoma. [8][9][10] Similar to classic nephrogenic adenoma, the current study demonstrated that the fibromyxoid variant also most commonly was seen in older males in the bladder. Nephrogenic adenoma in the renal pelvis is very rare, with <20 cases reported in the literature including 1 fibromyxoid variant.…”

Section: Discussionmentioning

confidence: 68%

Fibromyxoid Nephrogenic Adenoma

Li¹,

Williamson

Castillo

et al. 2022

American Journal of Surgical Pathology

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Nephrogenic adenoma is a benign epithelial lesion of the genitourinary tract that arises from the reimplantation and proliferation of shed renal tubular cells in areas of urothelial injury and denudation. Fibromyxoid nephrogenic adenoma is a rare variant that consists of compressed spindle-shaped renal epithelial cells in a fibromyxoid background. Only 14 observations of this variant are reported in the literature. We performed a retrospective analysis of fibromyxoid nephrogenic adenomas from 3 large reference centers. We identified 43 lesions in 6 women and 36 men (2 in 1 man) with a median age of 72 years (range, 31 to 94 y). Median lesion size was 0.7 cm (range, 0.2 to 5 cm). Nephrogenic adenomas were in the bladder (n=15), prostate/prostatic urethra (n=14), kidney (n=7), ureter (n=3), penile urethra (n=3), and urethral diverticulum (n=1). One of the kidney lesions developed in an end-stage kidney and radiologically mimicked cancer. Of 37 patients with information, 36 had predisposing conditions including prior biopsy, transurethral resection of bladder tumor, resection, Foley catheter, BCG treatment, urinary stones, (chemo)radiation, or diverticulum. Only 4/37 (10.8%) had a history of prior irradiation. Fifteen lesions had pure fibromyxoid morphology and 28 were admixed classic and fibromyxoid patterns. Three nephrogenic adenomas involved prostatic stroma, 3 renal sinus fat, 2 muscularis propria (1 bladder, 1 renal pelvis), 1 perinephric fat, and 1 corpus spongiosum. Ten fibromyxoid nephrogenic adenomas were intermixed with urothelial carcinoma, 1 with prostate adenocarcinoma, and 1 with malignant melanoma. By immunohistochemistry, PAX8 was positive in all the examined lesions (n=31). Napsin A was negative in all examined fibromyxoid nephrogenic adenomas (n=30). Twenty of them had classic nephrogenic adenoma component which was positive for napsin A. Similar to classic nephrogenic adenoma, fibromyxoid nephrogenic adenoma can occur anywhere along the urinary tract and is associated with a prior history that causes urothelial injury. In nearly a quarter of the cases, fibromyxoid nephrogenic adenoma extended beyond the lamina propria. Unlike previously suggested, fibromyxoid nephrogenic adenoma is not specifically related to prior radiation therapy. Awareness of this variant is important to avoid misdiagnosis and overtreatment.

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Section: Discussionmentioning

confidence: 68%

Fibromyxoid Nephrogenic Adenoma

Li¹,

Williamson

Castillo

et al. 2022

American Journal of Surgical Pathology

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“…Hansel et al [ 13 ] first described a fibromyxoid variant of NA in 2007, after which the first case of fibromyxoid NA in the ureter was reported. [ 14 ] In addition, a flat pattern was first described in 2013, and was found in 8 of 15 cases of NA, often mixed with the more traditional tubular, polypoid, and papillary components. [ 15 ] Besides, they also found that flat pattern was a common histomorphological manifestation of NA but could be easily confused with atypical flat urothelial lesions.…”

Section: Discussionmentioning

confidence: 99%

Nephrogenic adenoma of the renal pelvis

Zhang¹,

Wu²,

Sun³

et al. 2021

Medicine

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Rationale: Nephrogenic adenoma (NA) is a rare benign lesion of the urinary tract, which rarely occurs in the renal pelvis. Only 19 cases have been reported in the literature. However, there is no detailed report on the clinicopathological features of NA of the renal pelvis. Patient concerns: This case report describes a 46-year-old male patient who was admitted to the hospital for one month because of painless gross hematuria with blood clots. He had a history of hyperuricemia and a family history of gastric cancer. Diagnoses: NA of the renal pelvis was diagnosed pathologically and immunohistochemical. Interventions: The patient underwent laparoscopic nephroureterectomy. Outcomes: The patient recovered well after the operation with no discomfort. In addition, we followed up with the patient regularly post-discharge (approximately 20 months). There were no obvious abnormalities in the results of routine urine culture, computed tomography scan of the abdomen, and cystoscopy during the follow-up period, and the symptoms disappeared completely and did not recur. Lessons: NA of the renal pelvis is extremely rare in the clinic, which can be easily misdiagnosed and overtreated. However, for pathological diagnosis of this disease, specific immunohistochemical staining for preoperative biopsy was reported to be significant, which should be considered by the urologists and pathologists.

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“…Definite diagnosis of the lesions can be made with histopathologic evaluation (11). Various growth patterns including tubular, tubulocystic, polypoid, papil- lary, fibromyxoid, and flat growth patterns have been defined in histopathologic examination (11,12). The most common growth pattern is tubular.…”

Section: Discussionmentioning

confidence: 99%

“…Papillary formations may be prominently simple or contain slight branches. Other growth patterns include solid islets, cell cords, and fibromyxoid growth, consisting of spindle cells in myxoid stroma (11,12). Nephrogenic adenomas do not typically exhibit widespread invasion; however they may exhibit focal or superficial involvement of the muscularis propria (13).…”

Section: Discussionmentioning

confidence: 99%

Nephrogenic adenomas of the urinary system: a clinicopathologic analysis of 30 cases

et al. 2021

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Objective: Nephrogenic adenomas (NA) are benign lesions that may occur in several sites throughout the urinary tract, from the renal pelvis to urethra, and especially in the bladder. They are strongly associated with urinary tract irritation, chronic inflammation, previous urologic surgery, and intravesical instrumentations. Our study aims to evaluate and present the clinicopathologic characteristics and findings of cases that were diagnosed with nephrogenic adenoma accompanied by relevant information from the literature. Material and Methods: Our study includes 30 patients who were pathologically diagnosed with NA from February 2005 to November 2017. Results: Among these patients, 63.3% were males and mean age was 60 years. The most common site of occurrence was the bladder (86.6%), followed by the ureter (6.7%) and the urethra (6.7%). Most patients presented with hematuria (36.7%). History of concurrent bladder cancer was present in 26.7% of patients, but there were no cases of de novo bladder cancer diagnosed after NA. Recurrence of NA after initial resection occurred in only 10% of patients who underwent follow-up cystoscopy. Nephrogenic adenoma is a rare lesion associated with nonspecific symptoms and endoscopic features. Definite diagnosis must be made after histological analysis of resected specimens. Conclusion: Nephrogenic adenoma is a rare lesion associated with nonspecific symptoms and nonspesific endoscopic features. A definite diagnosis must be after histological analysis of resected specimens. Keywords: nephrogenic adenoma, urothelial lesion, bladder, ureter

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Fibromyxoid Nephrogenic Adenoma in the Ureter

Cited by 8 publications

References 3 publications

Fibromyxoid Nephrogenic Adenoma

Fibromyxoid Nephrogenic Adenoma

Nephrogenic adenoma of the renal pelvis

Nephrogenic adenomas of the urinary system: a clinicopathologic analysis of 30 cases

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