Leukoplakia of the Renal Pelvis and the Bladder

Abeshouse, Benjamin S.; Tankin, Louis H.

doi:10.1016/s0022-5347(17)66701-6

Cited by 19 publications

(6 citation statements)

References 13 publications

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“…4,12 Previous reports, however, recommend complete excision of the metaplastic plaque and careful follow-up, because recurrence has been known. [4][5][6][7][8][9] The lesion in this case was peeled away easily from the parenchyma using standard biopsy forceps, allowing for pathologic review of tissue specimens and culture. After clearing away the tissuelike material, endoscopic biopsy of the attachment site of the lesion with fulguration was performed.…”

Section: Discussionmentioning

confidence: 99%

“…Although KDSM is a benign lesion, there are rare reports that find that it occurs concurrently with squamouscell carcinoma; however, a direct causal relationship has yet to be established. [1][2][3][4][5][6][7][8] The term KDSM is often interchanged with leukoplakia or cholesteatoma. Microscopically, all three conditions demonstrate squamous metaplasia of the transitional epithelium with subsequent keratinization.…”

Section: Introductionmentioning

confidence: 99%

“…2 Although the etiology of keratinizing squamous metaplasia has been debated, a common theme in many case reports is chronic inflammation secondary to recurrent infections or stones. 5,7,8,10,11 Treatment focuses on complete eradication of the lesion with proper pathologic evaluation and ranges from endoscopic and open nephron-sparing surgery to nephroureterectomy. We present a case of keratinizing squamous metaplasia of the renal calyx that was managed via percutaneous endoscopic resection.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic Management of Keratinizing Desquamative Squamous Metaplasia of the Upper Tract: A Case Report and Review of the Literature

Ganeshappa

Krambeck

Grignon

et al. 2009

Journal of Endourology

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Keratinizing desquamative squamous metaplasia (KDSM), also known as leukoplakia or cholesteatoma, of the genitourinary tract is a rare condition that is difficult to differentiate from a malignant process without surgical intervention. We present a case of KDSM of the upper urinary tract that was managed via percutaneous endoscopic approach. Although KDSM is a benign lesion, there are rare reports of it occurring concurrently with squamous-cell carcinoma; however, no direct causal relationship has been identified. This case demonstrates the ease with which KDSM can be removed by peeling it away from the underlying parenchyma; however, surgical intervention may not be necessary in the asymptomatic patient after evaluation has ruled out malignancy. Regardless of how KDSM is managed, follow-up is important because these lesions are known to recur.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endoscopic Management of Keratinizing Desquamative Squamous Metaplasia of the Upper Tract: A Case Report and Review of the Literature

Ganeshappa

Krambeck

Grignon

et al. 2009

Journal of Endourology

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“…Longstanding urinary infection has been considered an important predisposing factor (Heymann, 1905;Stirling and Ash, 1941;Connery, 1953;Abeshouse and Tankin, 1956;Politano, 1956;Holley and Mellinger, 1961;Smith, Webb, and Price, 1962;Clarke and Gherardi, 1962;Streitz, 1963;O'Flynn and Mullaney, 1967), a view which has experimental support (Ball, Field, Roe, and Walters, 1964). It is also widely believed to be precarcinomatous (Politano, 1956;Holley and Mellinger, 1961;Roe, 1964;Ball et al, 1964;O'Flynn and Mullaney, 1967).…”

Section: Discussionmentioning

confidence: 99%

The relationship between urinary infection, cystoscopic appearance, and pathology of the bladder in man

1974

J Clin Pathol

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The occurrence of squamous change in the bladder epithelium was studied in bladder biopsies from patients with recurrent urinary infections or symptoms of cystitis and comparisons were made with sections taken at necropsy from control subjects. Two types of squamous change, termed `vaginal' and `cornified', are described. Vaginal change was frequent in females, and seemed to be a normal finding in them, but was not observed in males. It did not seem to be caused by urinary infection. Cornified change was also common in females and was found in one (infected) man. Like vaginal change it was most often found in sections from the trigone. Urinary infection may predispose to its formation but we were unable to prove this. Squamous change did not seem to cause symptoms, and could not usually be recognized at cystoscopy. The varieties described are so common that they are unlikely to be markedly precarcinomatous.

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“…When these pearly plaques are disturbed, the underlying surface appears papillary and bleeds easily. Keratinization can affect any part of the bladder, including the prostatic urethra, but usually spares the ureteric orifices [2,12] .…”

Section: Pathologymentioning

confidence: 99%

Keratinizing Squamous Metaplasia of the Bladder: A Review

Ahmad¹,

Barnetson²,

Krishna³

2008

Urol Int

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Aims: Keratinizing squamous metaplasia is infrequently found in bladder biopsies and its clinical significance remains unclear, with studies linking it to the development of invasive squamous cell carcinoma. Once diagnosed, there is a dilemma how to treat and follow-up this group. Methods: We reviewed the literature on the topic with particular emphasis on natural history, management and subsequent follow-up. Results: Keratinizing squamous metaplasia of the bladder is rare. Pathognomonic findings on biopsy are required to confirm the diagnosis. Both synchronous diagnosis of urothelial tumour and subsequent tumour development on follow-up has been identified. Risk of malignant transformation increases in the presence of dysplasia as well as with extensive keratinization. Lesions should be treated with local transurethral resection. Considering the lack of evidence cystectomy cannot be justified for those with extensive lesions. Conclusion: Currently there is not enough data to identify keratinizing squamous metaplasia of the bladder as a pre-malignant condition; this term being reserved for those with obvious histological dysplasia. However at present all patients should undergo regular follow-up.

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Leukoplakia of the Renal Pelvis and the Bladder

Cited by 19 publications

References 13 publications

Endoscopic Management of Keratinizing Desquamative Squamous Metaplasia of the Upper Tract: A Case Report and Review of the Literature

Endoscopic Management of Keratinizing Desquamative Squamous Metaplasia of the Upper Tract: A Case Report and Review of the Literature

The relationship between urinary infection, cystoscopic appearance, and pathology of the bladder in man

Keratinizing Squamous Metaplasia of the Bladder: A Review

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