Inverted Urothelial Papilloma
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Inverted papilloma is a benign urothelial neoplasm that displays an anastomosing inverted growth pattern with absent to minimal cytologic atypia.
Inverted papillomas account for <1% of all bladder urothelial neoplasms. Most tumors are usually solitary but can be multifocal. The incidence of multifocality ranges from 1.3% to 4.4% (Sung et al. 2006; Hodges et al. 2011). Tumors are typically small, with a mean size of 12.8 mm and a common range of 1–50 mm, but rarely, tumors can be as large as 8 cm (Sung et al. 2006).
Most patients are usually in their sixth or seventh decade of life.
Tumors are typically more common in males; male-to-female ratio is 7:1.
Inverted papillomas are most commonly found in the trigone (41% of cases) followed by the lateral wall, and posterior wall. Less commonly they also occur in the upper urothelial tract and urethra.
Complete transurethral resection is the most...
References and Further Reading
- Amin, M. B., Smith, S. C., Reuter, V. E., Epstein, J. I., Grignon, D., Hansel, E. D., et al. (2015). Update for the practicing pathologist: The International Consultation On Urologic Disease-European association of urology consultation on bladder cancer. Modern Pathology, 28, 612–630.CrossRefGoogle Scholar
- Cheng, L., Davidson, D. D., Wang, M., et al. (2016). Telomerase reverse transcriptase (TERT) promoter mutation analysis of benign, malignant and reactive urothelial lesions reveals a subpopulation of inverted papilloma with immortalizing genetic change. Histopathology, 69, 107–113.CrossRefGoogle Scholar
- Jones, T. D., Zhang, S., Lopez-Beltran, A., et al. (2007). Urothelial carcinoma with an inverted growth pattern can be distinguished from inverted papilloma by fluorescence in-situ hybridization, immunohistochemistry, and morphologic analysis. The American Journal of Surgical Pathology, 31, 1861–1867.CrossRefGoogle Scholar
- Picozzi, S., Casellato, S., Bozzini, G., et al. (2013). Inverted papilloma of the bladder: A review and an analysis of the recent literature of 365 patients. Urologic Oncology.Google Scholar
- Sun, J. J., Wu, Y., Lu, Y. M., Zhang, H. Z., Wang, T., Yang, X. Q., et al. (2015). Immunohistochemistry and fluorescence in situ hybridization can inform the differential diagnosis of low-grade noninvasive urothelial carcinoma with an inverted growth pattern and inverted urothelial papilloma. PLoS ONE, 10(7), e0133530. https://doi.org/10.1371/journal.pone.0133530.CrossRefGoogle Scholar