Encyclopedia of Pathology

Living Edition
| Editors: J.H.J.M. van Krieken

Bladder Squamous Cell Papilloma

  • Vanessa Henriques
  • Maria Rosaria Raspollini
  • Antonio Lopez-BeltranEmail author
Living reference work entry
DOI: https://doi.org/10.1007/978-3-319-28845-1_4787-1



Exophytic core lined by cytologically benign squamous epithelium

Clinical Features

  • Incidence

    Uncommon finding, less than 1% of the papillary tumor of the bladder

  • Age

    It affects most commonly elderly patients (mean age of 65 years old).

  • Sex

    It affects females slightly more than males.

  • Site

    Bladder. Presentation symptoms include stress incontinence and gross hematuria (Guo et al. 2006).

  • Treatment

    Surgical resection of the papillary lesion

  • Outcome

    It is a benign tumor and rarely recurs. Squamous papilloma has been found associated with urothelial neoplasms of the bladder in a low proportion of cases and seems to add a very low risk factor for bladder cancer (Cheng et al. 2000; Guo et al. 2006).


On cystectomy/cystoscopy, the lesions present as whitish plaque-like or erythematous and villous lesions (Miliaras et al. 2013; Guo et al. 2006).


Histologically, they are characterized by an exophytic lesion with papillary architecture, covered by keratinizing squamous epithelium without atypia or koilocytic changes (Wang et al. 2013) (Fig. 1).
Fig. 1

Squamous cell papilloma

Molecular Features

The squamous papilloma is not associated with human papilloma virus infection (HPV), has no p53 nuclear accumulation, and is diploid (Cheng et al. 2000).

Epidermal growth factor receptor [EGFR] expression by immunohistochemistry was described in four of four squamous papilloma lesions tested (Guo et al. 2006).

Differential Diagnosis

Squamous papilloma must be differentiated from condyloma acuminatum and verrucous carcinoma (Cheng et al. 2000). Condyloma, unlike squamous papilloma, is HPV-related. Verrucous carcinoma is characterized by bland cytology without koilocytic changes, verrucoid architecture, and large masses without stromal invasion.

References and Further Reading

  1. Cheng, L., Leibovich, B. C., Cheville, J. C., et al. (2000). Squamous papilloma of the urinary tract is unrelated to condyloma acuminata. Cancer, 88, 1679–1686.CrossRefGoogle Scholar
  2. Guo, C. C., Fine, S. W., & Epstein, J. I. (2006). Noninvasive squamous lesions in the urinary bladder: A clinicopathologic analysis of 29 cases. The American Journal of Surgical Pathology., 30(7), 883–891.CrossRefGoogle Scholar
  3. Miliaras, D., Vakalopoulos, I., & Anagnostou, E. (2013). Squamous cell papilloma of the urinary bladder endoscopically mimicking cancer. Case Reports in Pathology, 2013, 486312.PubMedPubMedCentralGoogle Scholar
  4. Wang, L., Shabaik, A., & Hansel, D. E. (2013). Squamous lesions of the bladder. Diagnostic Histopathology, 19(10), 376–380.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Vanessa Henriques
    • 1
  • Maria Rosaria Raspollini
    • 2
  • Antonio Lopez-Beltran
    • 1
    • 3
    Email author
  1. 1.Pathology ServiceChampalimaud Clinical CenterLisbonPortugal
  2. 2.Histopathology and Molecular DiagnosticsUniversity Hospital CareggiFlorenceItaly
  3. 3.Department of Surgery and PathologyUniversity of Cordoba Medical SchoolCordobaSpain