Rare Fibroepithelial Polyp Extending Along the Ureter: A Case Report

Abstract

Background:Fibroepithelial polyps of the urinary tract are rare tumors, and their occurrence in the upper urinary tract is highly unusual.Case Report:This study reports a 9-year-old boy who presented to our clinic with complaints of unilateral flank pain and macroscopic hematuria. The direct urinary system graph did not show stone formation; therefore, magnetic resonance urography was performed. This revealed a filling defect in the left proximal ureter. On cystoscopy, a polyp was seen in the orifice of the left ureter, extending along the ureter. The polyp was resected by laser ablation and removed from the ureter. Histopathologic examination revealed a fibroepithelial polyp comprising fibrovascular stroma covered with transitional epithelium.Conclusion:Although extremely rare, a fibroepithelial polyp should be considered in the differential diagnosis when a young patient presents with flank pain and macroscopic hematuria. Endoscopic procedures may be the treatment of choice for polyps located in the upper ureter.

Management of lower urinary tract fibroepithelial polyps in children

“…Comparison with the adult population [12,14,29,30] indicates that the clinical presentation of FEP appears to be similar. The management, however, is not entirely the same.…”

“…They only rarely occur in females. They can affect the entire urinary tract, from the renal pelvis to the urethra [14][15][16]. They are mostly located in the bladder [5] or the urethra.…”

Laparoscopic approach for intermittent hydronephrosis caused by primary ureteral fibroepithelial polyps in children

“…Retrograde contrast-enhanced angiography and IVP are commonly used in the diagnosis of UFPs. 8 We can see the filling defects in IVP, which is the characteristic X-ray sign of ureteral polyps, because the polyps move with ureteral peristalsis. This image is called “earthworm peristalsis sign”.…”

Successful endoscopic treatment using thulium YAG laser for multiple ureteral fibroepithelial polyps in a pediatric patient

“…UFEPs are rare, benign, nonepithelial tumors that originate in the mesoderm of the urinary system. Most UFEPs are located in the distal ureter 1–3 . UFEPs cause ~3.3% of UPJ obstructions and are found in 0.5% of all pediatric patients undergoing pyeloplasty 3 …”