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Zhang F, Wu J, Sun Z, Xie D, Yang X, Wang W. Nephrogenic adenoma of the renal pelvis: A rare case report and review of the literature. Medicine (Baltimore) 2021; 100:e27025. [PMID: 34449477 PMCID: PMC8389872 DOI: 10.1097/md.0000000000027025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/05/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Nephrogenic adenoma (NA) is a rare benign lesion of the urinary tract, which rarely occurs in the renal pelvis. Only 19 cases have been reported in the literature. However, there is no detailed report on the clinicopathological features of NA of the renal pelvis. PATIENT CONCERNS This case report describes a 46-year-old male patient who was admitted to the hospital for one month because of painless gross hematuria with blood clots. He had a history of hyperuricemia and a family history of gastric cancer. DIAGNOSES NA of the renal pelvis was diagnosed pathologically and immunohistochemical. INTERVENTIONS The patient underwent laparoscopic nephroureterectomy. OUTCOMES The patient recovered well after the operation with no discomfort. In addition, we followed up with the patient regularly post-discharge (approximately 20 months). There were no obvious abnormalities in the results of routine urine culture, computed tomography scan of the abdomen, and cystoscopy during the follow-up period, and the symptoms disappeared completely and did not recur. LESSONS NA of the renal pelvis is extremely rare in the clinic, which can be easily misdiagnosed and overtreated. However, for pathological diagnosis of this disease, specific immunohistochemical staining for preoperative biopsy was reported to be significant, which should be considered by the urologists and pathologists.
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A Case Report of an Obstructing Ureteral Nephrogenic Adenoma in a Child Managed With Open Ileal Ureter. Urology 2020; 143:231-233. [PMID: 32439556 DOI: 10.1016/j.urology.2020.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/03/2020] [Accepted: 05/05/2020] [Indexed: 11/22/2022]
Abstract
Nephrogenic adenoma is a rare, benign lesion that can be encountered anywhere along the urinary tract. It is associated with genitourinary trauma, chronic inflammation, genitourinary surgery, renal transplant, urolithiasis, and radiation. In children, these lesions are almost exclusively found in the bladder. However, we report an unusual case of a 15-year-old boy with no prior urologic history who presented with an obstructing right ureteral nephrogenic adenoma that required an ileal ureter interposition and right ureterectomy.
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Santoni N, Cottrell L, Talia Jones JE, Bekarma HJ. Multifocal nephrogenic adenoma treated by intravesical sodium hyaluronate. Urol Ann 2020; 12:187-189. [PMID: 32565661 PMCID: PMC7292422 DOI: 10.4103/ua.ua_74_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 12/31/2019] [Indexed: 12/27/2022] Open
Abstract
Nephrogenic adenoma is a rare benign urinary tract lesion. There are pediatric cases that have been managed with intravesical sodium hyaluronate, but there are no published adult cases. We present the first case of an adult successfully treated with intravesical sodium hyaluronate without resection. A 77-year-old man was investigated with cystoscopy for lower urinary tract symptoms (LUTS) unresponsive to medical therapy. This revealed multifocal flat black bladder lesions. Biopsy showed the lesions to be nephrogenic adenoma. His LUTS were treated with 6 weeks of intravesical sodium hyaluronate. He returned 6 weeks later for resection of his bladder lesions. However, resection was abandoned as the bladder lesions had entirely resolved. The resolution of the bladder lesions following intravesical sodium hyaluronate was unexpected but does agree with existing literature. The two reported pediatric cases also suggest that intravesical sodium hyaluronate is therapeutic for nephrogenic adenoma.
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Affiliation(s)
- Nicola Santoni
- Department of Urology, University Hospital Ayr, Ayr, United Kingdom
| | - Lorna Cottrell
- Department of Pathology, Crosshouse Hospital, Kilmarnock, United Kingdom
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Shelmerdine SC, Lorenzo AJ, Gupta AA, Chavhan GB. Pearls and Pitfalls in Diagnosing Pediatric Urinary Bladder Masses. Radiographics 2017; 37:1872-1891. [DOI: 10.1148/rg.2017170031] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Susan C. Shelmerdine
- From the Department of Clinical Radiology, Great Ormond Street Hospital, London, England (S.C.S.); Departments of Urology (A.J.L.), Oncology (A.A.G.), and Diagnostic Imaging (G.B.C.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Department of Medical Imaging, University of Toronto, Toronto, Ont, Canada (G.B.C.)
| | - Armando J. Lorenzo
- From the Department of Clinical Radiology, Great Ormond Street Hospital, London, England (S.C.S.); Departments of Urology (A.J.L.), Oncology (A.A.G.), and Diagnostic Imaging (G.B.C.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Department of Medical Imaging, University of Toronto, Toronto, Ont, Canada (G.B.C.)
| | - Abha A. Gupta
- From the Department of Clinical Radiology, Great Ormond Street Hospital, London, England (S.C.S.); Departments of Urology (A.J.L.), Oncology (A.A.G.), and Diagnostic Imaging (G.B.C.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Department of Medical Imaging, University of Toronto, Toronto, Ont, Canada (G.B.C.)
| | - Govind B. Chavhan
- From the Department of Clinical Radiology, Great Ormond Street Hospital, London, England (S.C.S.); Departments of Urology (A.J.L.), Oncology (A.A.G.), and Diagnostic Imaging (G.B.C.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Department of Medical Imaging, University of Toronto, Toronto, Ont, Canada (G.B.C.)
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Özçift B, Kaçar A, Tiryaki HT. Recurrence of childhood nephrogenic adenoma in urinary bladder developed four years after previous surgery despite intravesical sodium hyaluronate therapy. Turk J Urol 2016; 42:303-306. [PMID: 27909627 DOI: 10.5152/tud.2016.84579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Nephrogenic adenoma (NA) is a rarely seen benign metaplastic lesion of the urinary tract. Its etiology is uncertain, but induced by chronic inflammation, irritation, and trauma. NA is located in the urinary tract, most commonly in the bladder. NA usually presents with hematuria and lower urinary tract symptoms. In the literature it is mostly seen in adults but about 30 cases of NA's have been reported in children. Treatment of intravesical lesions consists of transurethral resection (TUR) and fulguration and rarely partial or total cystectomy may be required in ineffective TUR. Recurrence rate is high during long-term follow-up. The intravesical application of sodium hyaluronate produces a protective effect on the glycosaminoglycan layer and delays or prevents its recurrence. We report a case of recurrent NA of the bladder in a pediatric male patient who was presented four years after previous surgery despite intravesical sodium hyaluronate therapy.
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Affiliation(s)
- Burak Özçift
- Clinic of Pediatric Urology, Ankara Child Health and Diseases Hematology Oncology Education and Research Hospital, Ankara, Turkey
| | - Ayper Kaçar
- Clinic of Pathology, Ankara Child Health and Diseases Hematology Oncology Education and Research Hospital, Ankara, Turkey
| | - Hüseyin Tuğrul Tiryaki
- Clinic of Pediatric Urology, Ankara Child Health and Diseases Hematology Oncology Education and Research Hospital, Ankara, Turkey
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Koenig JF, Rensing A, Austin PF, Vricella G. First-ever Reported Obstructing Ureteral Nephrogenic Adenoma in a Child and Subsequent Robotic-assisted Laparoscopic Ileal Ureter. Urology 2016; 94:221-3. [DOI: 10.1016/j.urology.2016.03.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/03/2016] [Accepted: 03/08/2016] [Indexed: 11/24/2022]
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Gordetsky J, Gennaro KH, Selph JP, Rais-Bahrami S. Nephrogenic Adenoma: Clinical Features, Management, and Diagnostic Pitfalls. Urology 2016; 95:29-33. [PMID: 27138263 DOI: 10.1016/j.urology.2016.04.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 04/20/2016] [Accepted: 04/26/2016] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To review the diagnosis and management of nephrogenic adenoma (NA), an uncommon benign lesion found in the urinary tract. This lesion arises from a proliferation of implanted renal tubular cells. Although more common in adults, it can occur in all ages. NAs can recur and cause significant morbidity in patients. NAs are also a potential diagnostic pitfall as they can clinically and histologically mimic malignancy in the urinary tract. MATERIALS AND METHODS We performed an Institutional Board Review approved search of our surgical pathology database from 2005 to 2015 for cases of NA. A retrospective chart review was performed with a focus on the clinical, pathologic, and radiographic findings in these patients. RESULTS We identified 32 cases of NA in 31 patients. Lesions were most common in Caucasian males (male-to-female ratio of 2:1) with an average age at diagnosis of 55 years (range 25-77). Bladder was the most common site of occurrence (81.2%), followed by ureter (9.4%), urethra (6.3%), and intrarenal collecting system (3.1%). Most patients (72%) were symptomatic and presented with hematuria (41%), lower urinary tract symptoms (28%), pelvic or flank pain (6%), hydronephrosis (19%), or urinary incontinence (13%). NA was asymptomatic and identified incidentally in 9 (28%) patients. One patient (3%) had a renal transplant and 8 (26%) patients had diabetes mellitus. Twenty-six (84%) patients were managed with endoscopic resection of their tumors. CONCLUSION NAs are benign lesions that may cause significant morbidity and mimic malignant tumors. There should be increased suspicion in patients with predisposing factors.
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Affiliation(s)
- Jennifer Gordetsky
- University of Alabama at Birmingham, Department of Pathology, Birmingham, AL; University of Alabama at Birmingham, Department of Urology, Birmingham, AL.
| | - Kyle H Gennaro
- University of Alabama, School of Medicine, Birmingham, AL
| | - John P Selph
- University of Alabama at Birmingham, Department of Urology, Birmingham, AL
| | - Soroush Rais-Bahrami
- University of Alabama at Birmingham, Department of Urology, Birmingham, AL; University of Alabama at Birmingham, Department of Radiology, Birmingham, AL
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Ishikawa N, Amano C, Taketani T, Kumori K, Harada Y, Hiraiwa H, Itamura K, Maruyama R. Diffuse and multifocal nephrogenic adenoma with Familial Mediterranean Fever: a case report with molecular study. Diagn Pathol 2015; 10:104. [PMID: 26428868 PMCID: PMC4589953 DOI: 10.1186/s13000-015-0344-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 07/08/2015] [Indexed: 01/22/2023] Open
Abstract
Nephrogenic adenoma, also referred to nephrogenic metaplasia, is a benign proliferative lesion of urothelium, usually associated with chronic physical stimuli or inflammation. Familial Mediterranean fever is an inherited autosomal recessive disease characterized by recurrent short episodes of fever. The site of mutation is found in MEFV gene which controls inflammatory responses. We have experienced a case of nephrogenic adenoma in a 16-year-old girl with Familial Mediterranean Fever, showing proliferative lesions diffusely in the urinary bladder and multifocally in the other parts of urinary tract. These lesions disappeared after colchicine treatment. We searched for MEFV gene mutation using the specimen from the resected urinary bladder and detected heterozygous mutation of E148Q. There is a possibility that control of inflammation caused by the surgery for vesicoureteral reflux in the local site didn’t work well on the background of heterozygous mutation of MEFV gene, and as a result, nephrogenic adenoma appeared. This is the first report of a combination of two rare diseases. We have to be aware that nephrogenic adenoma can occur in association with Familial Mediterranean Fever, and the former condition should be taken into consideration when rendering a correct pathological diagnosis.
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Affiliation(s)
- Noriyoshi Ishikawa
- Department of Pathology (Organ Pathology Unit), 89-1 Enya, Izumo, Shimane, 693-8501, Japan.
| | - Chika Amano
- Department of Pathology (Functional Pathology Unit), Shimane University School of Medicine, Shimane, 693-8501, Japan.
| | - Takeshi Taketani
- Department of Pediatrics, Shimane University School of Medicine, Shimane, 693-8501, Japan.
| | - Koji Kumori
- Department of Digestive and General Surgery, Shimane University School of Medicine, Shimane, 693-8501, Japan.
| | - Yuji Harada
- Laboratory of Surgical Pathology, Shimane University Hospital, Shimane, 693-8501, Japan.
| | - Hisayuki Hiraiwa
- Department of Pediatrics, Eastern Shimane Rehabilitation Hospital, Shimane, 693-8501, Japan.
| | - Kayoko Itamura
- Department of Pediatrics, Eastern Shimane Rehabilitation Hospital, Shimane, 693-8501, Japan.
| | - Riruke Maruyama
- Department of Pathology (Organ Pathology Unit), 89-1 Enya, Izumo, Shimane, 693-8501, Japan. .,Laboratory of Surgical Pathology, Shimane University Hospital, Shimane, 693-8501, Japan.
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Nephrogenic Adenoma of the Urinary Bladder: A Review of the Literature. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2015; 2015:704982. [PMID: 27347540 PMCID: PMC4897129 DOI: 10.1155/2015/704982] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 11/20/2014] [Indexed: 11/17/2022]
Abstract
Background. Nephrogenic adenoma of the urinary bladder (NAUB) is a rare lesion associated with nonspecific symptoms and could inadvertently be misdiagnosed. Aim. To review the literature. Methods. Various internet search engines were used. Results. NAUB is a benign tubular and papillary lesion of the bladder, is more common in men and adults, and has been associated with chronic inflammation/irritation, previous bladder surgery, diverticula, renal transplantation, and intravesical BCG; recurrences and malignant transformations have been reported. Differential diagnoses include clear cell adenocarcinoma, endocervicosis, papillary urothelial carcinoma, prostatic adenocarcinoma of bladder, and nested variant of urothelial carcinoma; most NAUBs have both surface papillary and submucosal tubular components; both the papillae and tubules tend to be lined by a single layer of mitotically inactive bland cells which have pale to clear cytoplasm. Diagnosis may be established by using immunohistochemistry (positive staining with racemase; PAX2; keratins stain positive with fibromyxoid variant), electron microscopy, DNA analysis, and cytological studies. Treatment. Endoscopic resection is the treatment but recurrences including sporadic malignant transformation have been reported. Conclusions. There is no consensus on best treatment. A multicentre study is required to identify the treatment that would reduce the recurrence rate, taking into consideration that intravesical BCG is associated with NAUB.
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Rensing AJ, Koenig JF, Vricella GJ, Sehn JK. Nephrogenic adenoma of the pediatric ureter. J Urol 2015; 193:1377-8. [PMID: 25598138 DOI: 10.1016/j.juro.2015.01.067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Adam J Rensing
- Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Joel F Koenig
- Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Gino J Vricella
- Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Jennifer K Sehn
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
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Recurrent Nephrogenic Adenoma: A Case Report of Resolution After Treatment With Antibiotics and Nonsteroidal Anti-inflammatory Medication. Urology 2013; 82:1156-7. [DOI: 10.1016/j.urology.2013.04.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 04/03/2013] [Accepted: 04/12/2013] [Indexed: 11/20/2022]
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Rossi E, Pavanello P, Marzola A, Franchella A. Eosinophilic cystitis and nephrogenic adenoma of the bladder: a rare association of 2 unusual findings in childhood. J Pediatr Surg 2011; 46:e31-e34. [PMID: 21496523 DOI: 10.1016/j.jpedsurg.2010.12.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 12/28/2010] [Accepted: 12/29/2010] [Indexed: 11/16/2022]
Abstract
Neither eosinophilic cystitis nor nephrogenic adenoma is often diagnosed in children, with few pediatric cases being reported in the literature. Although these maladies share the same predisposing conditions, namely, chronic irritation or injury to the urothelium and lower urinary tract and symptoms such as dysuria, hematuria, and urinary frequency, their concomitance is exceptional. Herein, we report the case of an 8-year-old boy with a previous history of bladder surgery presenting histologically diagnosed eosinophilic cystitis and nephrogenic adenoma.
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Affiliation(s)
- Enrica Rossi
- Pediatric Surgery Department, Sant'Anna Hospital, Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy.
| | - Piero Pavanello
- Pediatric Surgery Department, Sant'Anna Hospital, Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy.
| | - Andrea Marzola
- Institute of Pathology, University of Ferrara, Via Fossato di Mortara, 64, 44100 Ferrara, Italy.
| | - Andrea Franchella
- Pediatric Surgery Department, Sant'Anna Hospital, Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy.
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Broecker JS, Steelman CK, Broecker BH, Shehata BM. Nephrogenic adenoma of the bladder in a prune belly syndrome patient: case report and review of the literature. Fetal Pediatr Pathol 2011; 30:296-300. [PMID: 21843046 DOI: 10.3109/15513815.2011.572958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Nephrogenic adenoma (NA) is a rare lesion of the urinary tract widely considered to be a metaplastic response to urothelial injury. Herein, we present the case of an 8-year-old male with prune belly syndrome who presented with gross hematuria. Investigation revealed a bladder mass; however, upon cystoscopic examination, multiple polypoid lesions were identified. Microscopic examination revealed NA of the bladder. To our knowledge, this is the second reported case of NA of the bladder in association with prune belly syndrome.
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Affiliation(s)
- Justine S Broecker
- Department of Pediatric Pathology, Children's Healthcare of Atlanta, Atlanta, GA 30322-1101, USA
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Filly RA, Baskin LS. Multifocal nephrogenic adenoma of the bladder in a pediatric patient. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:1239-1241. [PMID: 20660459 DOI: 10.7863/jum.2010.29.8.1239] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Roy A Filly
- Department of Radiology, University of California, San Francisco, CA 94143-0628, USA.
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