Nephrogenic Adenoma in a Patient with Transitional Cell Carcinoma of the Bladder Receiving Intravesical Bacillus Calmette‐Guérin

Abstract

A 76-year-old-man was admitted to our hospital for a recurrent bladder tumor. He had received intravesical bacillus Calmette-Guérin (BCG) treatment for a transitional cell carcinoma of the bladder. A follow-up cystoscopy revealed a solitary papillary tumor in the left bladder wall. A transurethral cold cup biopsy revealed a nephrogenic adenoma without any evidence of malignant cells. We discuss the pathogenesis of nephrogenic adenoma and suggest that prolonged cystitis caused by intravesical BCG may play an etiological role.

Recurrence of childhood nephrogenic adenoma in urinary bladder developed four years after previous surgery despite intravesical sodium hyaluronate therapy

“…Its common localization is on the bladder wall; and generally lesions are less than 1 cm in size and limited up to 7 cm. [3,9,11] Histopathological study is needed to distinguish it from malignancy. [12] NA generally demonstrates multiple histologic patterns, with a minority composing of small tubules or papillary projections alone.…”

Nephrogenic Adenoma of the Bladder after Intravesical Bacillus Calmette-Guérin Treatment

“…Tubule-like structures lined by cuboidal cells and a mild to moderate chronic inflammatory infiltrate may be present in the stroma [1,4,10]. There is no characteristic endoscopic appearance for nephrogenic adenoma and the lesions can be flat, polypoid or papillary [1,2,4,9]. The endoscopic appearance of nephrogenic adenoma in Stilmant-Siroky's, Oyama's and Wood's patients was in the form of micropapillary tumors that were indistinguishable from carcinoma of the bladder [1,2,9].…”

“…The lesion was first described by Davis [6] in 1949, but Friedman and Kuhlenbeck [7] were to name it as nephrogenic adenoma considering its resemblance to primitive renal collecting tubules. The occurrence of nephrogenic adenoma after intravesical bacillus Calmette-Guérin (BCG) treatment is very rare and only few cases have been reported in the literature [1,3,8,9]. We like to present a case of nephrogenic adenoma considered to be associated with intravesical BCG treatment.…”

“…The etiology of nephrogenic adenoma is unclear but it is generally considered to be a metaplastic change of urothelium to irritative factors such as infection, trauma, surgery, calculi and chemical agents [1][2][3][4][5][6][7][8][9]. Almost all cases presented in the literature have a history of the factors listed above supporting this theory [1][2][3][4][5][6][7][8][9].…”

“…Almost all cases presented in the literature have a history of the factors listed above supporting this theory [1][2][3][4][5][6][7][8][9]. The lesion may occur anywhere in the urinary tract, the bladder being the most common location [4].…”