Villous adenoma of the renal pelvis: a common entity at an uncommon location
DOI:
https://doi.org/10.4322/acr.2021.283Keywords:
Kidney pelvis, adenoma, villous, hydronephrosis, pyonephrosisAbstract
Villous adenoma is uncommonly seen in the urogenital tract and is even more rarely seen in the upper urinary tract and renal pelvis. Like colorectal adenomas, these neoplasms can transform into adenocarcinoma. The preoperative diagnosis is challenging due to their frequent association with hydronephrosis. Herein, we present the case of a villous adenoma of the renal pelvis in a 62-year-old man presenting with recurrent urinary tract infection. The computed tomography scan showed marked hydronephrosis but no suspicious mass in the right kidney. A laparoscopic right nephrectomy was performed. Gross examination revealed a dilated renal pelvis with an irregular exophytic lesion in the renal pelvis’s upper surface. The histopathological examination showed slender, elongated villi with thin fibrovascular cores, consistent with villous adenoma morphology. Isolated villous adenomas have a favorable prognosis. However, the pathologist should undertake a search for an invasive component.
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Seibel JL, Prasad S, Weiss RE, Bancila E, Epstein JI. Villous adenoma of the urinary tract: a lesion frequently associated with malignancy. Hum Pathol. 2002;33(2):236-41. http://dx.doi.org/10.1053/hupa.2002.31293.
Cheng L, Montironi R, Bostwick DG. Villous adenoma of the urinary tract: a report of 23 cases, including 8 with coexistent adenocarcinoma. Am J Surg Pathol. 1999;23(7):764-71. http://dx.doi.org/10.1097/00000478-199907000-00003. PMid:10403298.
Huang TY, Yang SF, Huang SP, Yeh HC, Li CC. Villous adenoma of the renal pelvis: A case report and literature review. Urol Sci. 2014;25(3):101-3. http://dx.doi.org/10.1016/j.urols.2013.06.004.
Bhat S, Chandran V. Villous adenoma of the renal pelvis and ureter. Indian J Urol. 2010;26(4):598-9. http://dx.doi.org/10.4103/0970-1591.74478. PMid:21369402.
Assor D. A villous tumor of the bladder. J Urol. 1978;119(2):287-8. http://dx.doi.org/10.1016/S0022-5347(17)57461-3. PMid:633500.
Park S, Meng MV, Greenberg MS, Deng DY, Stoller ML. Muconephrosis. Urology. 2002;60(2):344. http://dx.doi.org/10.1016/s0090-4295(02)01707-7. PMID: 12137843.
Stoykov B, Kolev N, Dunev V, Genov P, Atanasov J, Mateva S. A rare case of huge villous adenoma of the renal pelvis deforming the abdominal wall. Urol Case Rep. 2020;31:101183. http://dx.doi.org/10.1016/j.eucr.2020.101183. PMid:32309146.
Nayak A, Depasquale B, Vergara N, Guzzo TA, Lal P. Villous Adenoma Arising in the Native Bladder Mucosa and the Upper Urinary Tract With Coexisting Neuroendocrine Carcinoma Following Augmentation Cystoplasty. Int J Surg Pathol. 2019;27(4):450-6. http://dx.doi.org/10.1177/1066896919826708. PMid:30701999.
Liu D, Tan J, Huang K, Jiang Z, He L, Yin G. Villous adenoma in renal pelvis with manifestation of percutaneous fistula and mucus secretion. Urology. 2017;102:e3-4. http://dx.doi.org/10.1016/j.urology.2016.12.051. PMid:28069333.
Bote SM, Siddiqui MA, Gite VA, Patil SR, Menon S. Villous adenoma of renal pelvis with muconephrosis: a case report. Arch Int Surg. 2016;6(3):183-5. http://dx.doi.org/10.4103/2278-9596.202364.
Dong C, Yang Y, Wu S, Chen G. Clinicopathological analysis of two cases with pelvis villous adenoma and review of relevant literature. J Cancer Res Ther. 2015;11(3):663. http://dx.doi.org/10.4103/0973-1482.144653. PMid:26458689.
Patel RD, Vanikar AV, Modi PR. Mucinous cystadenocarcinoma of renal pelvis presenting as pyonephrosis. Saudi J Kidney Dis Transpl. 2014;25(3):647-50. http://dx.doi.org/10.4103/1319-2442.132224. PMid:24821168.
Sagnotta A, Dente M, Socciarelli F, Cacchi C, Stoppacciaro A, Balducci G. Primary adenocarcinoma of the renal pelvis: histologic features of a stepwise process from intestinal hyperplasia to dysplasia in a patient with chronic renal abscess. Int J Surg Pathol. 2014;22(2):182-5. http://dx.doi.org/10.1177/1066896913502225. PMid:24008439.
Hudson J, Arnason T, Merrimen JL, Lawen J. Intestinal type villous adenoma of the renal pelvis. Can Urol Assoc J. 2013;7(1-2):E138-42. http://dx.doi.org/10.5489/cuaj.257. PMid:23671505.
Karnjanawanichkul W, Tanthanuch M, Mitarnun W, Pripatnanont C. Renal pelvic villous adenoma presented with mucusuria: report of a case and literature review. Int J Urol. 2013;20(2):247-9. http://dx.doi.org/10.1111/j.1442-2042.2012.03144.x. PMid:22934691.
Fudge KG, Glicklich D, Golestaneh L, Pullman J. Villous adenoma in the native kidney of a renal transplant recipient. Transplantation. 2006;81(4):638. http://dx.doi.org/10.1097/01.tp.0000188617.65532.1d. PMid:16495818.
Shah VB, Amonkar GP, Deshpande JR, Bhalekar H. Mucinous adenocarcinoma of the renal pelvis with pseudomyxoma peritonei. Indian J Pathol Microbiol. 2008;51(4):536-7. http://dx.doi.org/10.4103/0377-4929.43753. PMid:19008588.
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