Rare Combination of Fibroepithelial Polyp and Kidney Cancer in a Patient With Bladder Cancer
Posted: Wednesday, November 10, 2021
A case study presented in the Journal of Medical Case Reports described a rare combination of fibroepithelial polyps associated with renal cell carcinoma in a patient who has non-muscle invasive bladder cancer. In many cases, patients with these types of polyps are treated with unnecessary ureterectomy, explained Serkan Akan, MD, and Canar Ediz, MD, of the University of Health Sciences, Istanbul, and colleagues. However, in this particular case, the patient avoided such surgery because of early detection.
“Although our patient had bladder transitional cell carcinoma and a suspicious renal cell carcinoma mass of 15 mm in the ipsilateral kidney, the patient was safeguarded from unnecessary nephroureterectomy early on by cross-sectional and endoscopic imaging of the ureter,” the authors concluded.
An asymptomatic 59-year-old man is under follow-up care for Ta low-grade transitional cell bladder cancer from years prior. While examining the patient, the physicians found a “suspicious, solid, contrast-enhancing” mass in the anteromedial mid-section of the left kidney (15 x 9 mm). The mass was causing minimal washout and was largely located in the parenchyma. It was then diagnosed as renal cell carcinoma on CT.
The authors discovered soft-tissue densities approximately 300 mm in length during the excretory phase, which suggested a ureteral carcinoma. Following a histopathologic examination, urothelial lesions were considered to be fibroepithelial polyps. A partial nephrectomy for the mass was performed in the first postoperative month. A following histopathologic examination revealed Fuhrman grade 1 papillary type renal cell carcinoma. In the year after treatment, no recurrence of disease has been observed.
“In the presence of suspicious lesions that preoperative and intraoperative findings cannot clearly define, intraoperative frozen section evaluation of the tissue sample can be performed,” the authors noted. “Fulgurization of the tumor base will minimize the possibility of recurrence at the expense of bleeding risk.”
Disclosure: The authors reported no conflicts of interest.