A clinical and molecular review of inverted papilloma of the urinary tract: how to handle?

Jørgensen, Peter Hjorth; Vainer, Ben; Hermann, Gregers G.

doi:10.1111/apm.12456

Cited by 4 publications

(3 citation statements)

References 66 publications

(90 reference statements)

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“…Irritative symptoms, as well as urinary tract obstruction, have also been reported [55]. In a high percentage of cases, however, tumours are asymptomatic and detected during unrelated clinical investigations.…”

Section: Discussionmentioning

confidence: 98%

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Inverted urothelial papilloma of the upper urinary tract: description of two cases with systematic literature review

et al. 2020

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Background: Inverted urothelial papilloma (IUP) of the upper urinary tract is an uncommon benign tumour that occasionally presents as a polypoid mass causing urinary obstruction. Histologically, IUP is characterised by a proliferating urothelium arranged in cords and trabeculae, in continuity with overlying intact epithelium, and extending into the lamina propria in a non-invasive, endophytic manner. Cytological atypia is minimal or absent. Top differential diagnoses include urothelial carcinoma with inverted growth pattern and florid ureteritis cystica. Although urothelial carcinomas of the upper urinary tract with prominent inverted growth pattern commonly harbour microsatellite instability, the role of the mutator phenotype pathway in IUP development is still unclear. The aim of this study was to describe two additional cases of IUP of the upper urinary tract, along with an extensive literature review. Case presentation: We observed two polypoid tumours originating in the renal pelvis and the distal ureter, respectively. Both patients, a 76-year-old woman and a 56-year-old man, underwent surgery because of the increased likelihood of malignancy. Histology was consistent with IUP and patients are alive and asymptomatic after long-term follow-up (6 years for the renal pelvis lesion and 5 years for the ureter lesion). The tumours retained the expression of the mismatch-repair protein MLH1, MSH2, and PMS2 whereas loss of MSH6 was found in both cases. Conclusions: When completely resected, IUP does not require rigorous surveillance protocols, such as those for urothelial carcinoma and exophytic urothelial papilloma. It is therefore important for the surgical pathologist to be aware of this rare entity in order to ensure correct patient management.

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Section: Discussionmentioning

confidence: 98%

“…Most tumours measure less than 3 cm in diameter but can reach up to 8 cm or more. They usually occur as solitary lesions, although 3.6-6% are bilateral or multicentric [55].…”

Section: Discussionmentioning

confidence: 99%

Inverted urothelial papilloma of the upper urinary tract: description of two cases with systematic literature review

et al. 2020

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“…IPB exhibits slow growth and regular morphology, with its surface being covered by normal urinary tract epithelium and without involving the muscle layer. There, there is no significant difference between the lesion margin and the adjacent bladder wall [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Quantitative differentiation of non-invasive bladder urothelial carcinoma and inverted papilloma based on CT urography

Jin,

Yang,

Liu

et al. 2024

BMC Urol

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Purpose To investigate the value of CT urography (CTU) indicators in the quantitative differential diagnosis of bladder urothelial carcinoma (BUC) and inverted papilloma of the bladder (IPB). Material and methods The clinical and preoperative CTU imaging data of continuous 103 patients with histologically confirmed BUC or IPB were retrospectively analyzed. The imaging data included 6 qualitative indicators and 7 quantitative measures. The recorded clinical information and imaging features were subjected to univariate and multivariate logistic regression analysis to find independent risk factors for BUC, and a combined multi-indicator prediction model was constructed, and the prediction model was visualized using nomogram. ROC curve analysis was used to calculate and compare the predictive efficacy of independent risk factors and nomogram. Results Junction smoothness, maximum longitudinal diameter, tumor-wall interface and arterial reinforcement rate were independent risk factors for distinguishing BUC from IPB. The AUC of the combined model was 0.934 (sensitivity = 0.808, specificity = 0.920, accuracy = 0.835), and its diagnostic efficiency was higher than that of junction smoothness (AUC=0.667, sensitivity = 0.654, specificity = 0.680, accuracy = 0.660), maximum longitudinal diameter (AUC=0.757, sensitivity = 0.833, specificity = 0.604, accuracy = 0.786), tumor-wall interface (AUC=0.888, sensitivity = 0.755, specificity = 0.808, accuracy = 0.816) and Arterial reinforcement rate (AUC=0.786, sensitivity = 0.936, specificity = 0.640, accuracy = 0.864). Conclusion Above qualitative and quantitative indicators based on CTU and the combination of them may be helpful to the differential diagnosis of BUC and IPB, thus better assisting in clinical decision-making. Key points 1. Bladder urothelial carcinoma (BUC) and inverted papilloma of the bladder (IPB) exhibit similar clinical symptoms and imaging presentations. 2. The diagnostic value of CT urography (CTU) in distinguishing between BUC and IPB has not been documented. 3. BUC and IPB differ in lesion size, growth pattern and blood supply. 4. The diagnostic efficiency is optimized by integrating multiple independent risk factors into the prediction model.

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Inverted papilloma of the urinary bladder shows fluorescence on photodynamic diagnosis using 5-aminolevulinic acid

Oshina

Kawai

Sato

et al. 2020

Photodiagnosis and Photodynamic Therapy

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A clinical and molecular review of inverted papilloma of the urinary tract: how to handle?

Cited by 4 publications

References 66 publications

Inverted urothelial papilloma of the upper urinary tract: description of two cases with systematic literature review

Inverted urothelial papilloma of the upper urinary tract: description of two cases with systematic literature review

Quantitative differentiation of non-invasive bladder urothelial carcinoma and inverted papilloma based on CT urography

Inverted papilloma of the urinary bladder shows fluorescence on photodynamic diagnosis using 5-aminolevulinic acid

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