1
|
Pescia C, Pini G, Lopez G, Malfatto M, Brescia G, Tabano S, Del Gobbo A. A Rare Case of Urinary Bladder Hamartoma Clinically Mimicking an Urothelial Carcinoma: A Case Report and Review of the Literature. Int J Surg Pathol 2023; 31:1572-1579. [PMID: 36938586 PMCID: PMC10616991 DOI: 10.1177/10668969231159314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 03/21/2023]
Abstract
Urinary bladder hamartoma is a rare benign proliferation with only 14 cases reported in the literature at present. Urinary bladder hamartoma is composed of a disorderly admixture of normal urinary bladder components, essentially represented by glands lined by transitional epithelium and a variable percentage of fibrous stroma, smooth muscle bundles, and adipose tissue. Urinary bladder hamartomas do not exhibit cytological or architectural abnormalities and show no necrosis or increase in mitotic activity. Clinical manifestations are usually represented by lower urinary tract symptoms, more or less frequently paired with gross hematuria. Several pediatric cases of urinary bladder hamartoma have been reported, sometimes with syndromic associations. Transurethral resection has been curative in all cases reported, with no evidence of recurrence. Here we report an additional rare urinary bladder hamartoma, clinically mimicking urothelial carcinoma, providing a review of the literature regarding this unusual entity.
Collapse
Affiliation(s)
- Carlo Pescia
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuditta Pini
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Lopez
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Matteo Malfatto
- Division of Urology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gloria Brescia
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Silvia Tabano
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Molecular Genetics Laboratory, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandro Del Gobbo
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
2
|
Kumar J, Albeerdy MI, Shaikh NA, Qureshi AH. Bladder hamartoma in Peutz-Jeghers syndrome: a rare case report. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00172-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Peutz-Jeghers syndrome is an autosomal dominant disease characterized by mucocutaneous pigmentation and hamartomatous polyps in the gastrointestinal tract (GIT). There have also been cases of extra GIT polyps such as the renal pelvis, urinary bladder, lungs and nares. Bladder hamartoma is an extremely rare finding, with only 12 cases described in the literature up to now. The rarity of the condition necessitates a comprehensive compilation of managements up to now so as to provide a better tool for the treatment of such conditions in the future.
Case presentation
A twenty-year-old male, known to have Peutz-Jeghers syndrome, presented to us complaining of obstructive urinary symptoms. A urethrogram done showed a filling defect at the base of the urinary bladder. The mass was resected transurethrally, and histopathology revealed a hamartoma of the bladder. The patient has since remained tumor-free on follow-up.
Conclusions
Transurethral resection of the bladder mass proved to be an effective therapy in this patient with no recurrence on the patient’s follow-up till now. There is still, however, a dearth of knowledge regarding the management of bladder hamartomas owing to the extreme rarity of the case.
Collapse
|
3
|
Ahn AR, Song JS, Do Yang J, Moon WS. Pancreatic hamartoma mimicking neuroendocrine tumor. Pathol Int 2021; 71:789-791. [PMID: 34416074 DOI: 10.1111/pin.13153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/14/2021] [Accepted: 08/06/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Ae Ri Ahn
- Department of Pathology, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, and Research Institute for Endocrine Sciences, Jeonju, Jeonbuk, Republic of Korea
| | - Ji Soo Song
- Department of Radiology, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, and Research Institute for Endocrine Sciences, Jeonju, Jeonbuk, Republic of Korea
| | - Jae Do Yang
- Department of General Surgery, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, and Research Institute for Endocrine Sciences, Jeonju, Jeonbuk, Republic of Korea
| | - Woo Sung Moon
- Department of Pathology, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, and Research Institute for Endocrine Sciences, Jeonju, Jeonbuk, Republic of Korea
| |
Collapse
|
4
|
Katayama H, Azuma K, Koneri K, Murakami M, Hirono Y, Hatta S, Imamura Y, Goi T. A typical case of resected pancreatic hamartoma: a case report and literature review on imaging and pathology. Surg Case Rep 2020; 6:107. [PMID: 32448918 PMCID: PMC7246275 DOI: 10.1186/s40792-020-00869-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 05/11/2020] [Indexed: 12/30/2022] Open
Abstract
Background Pancreatic hamartomas are rare entities and difficult to diagnose before resection. We report a case of resected pancreatic hamartoma and literature review of typical characteristics of the lesion. Case presentation A 78-year-old man presented with a mass in his pancreas, which was incidentally identified when he experienced pneumonia. No remarkable symptoms were observed, and laboratory tests showed no abnormalities, except a slight carcinoembryonic antigen elevation. Enhanced computed tomography and magnetic resonance imaging showed a well-demarcated solid mass with heterogeneous contrast that was 2 cm in size. A gradual enhancement pattern was also observed. The biopsy revealed no specific findings; therefore, surgical resection was necessitated to confirm the diagnosis. Histopathologically, ducts, acinar cells, and adipose cells without atypia were observed among abundant fibrous stroma, but islets of Langerhans and peripheral nerves were absent. An immunohistochemical examination demonstrated CD34 and c-kit positive staining in the stromal cells, S-100 positivity in the adipose cells, and a lack of elastic fibers in the duct walls. The lesion was diagnosed as a pancreatic hamartoma. Conclusion Asymptomatic pancreatic hamartomas can avoid resection. A careful consideration of imaging and appropriate immunohistochemistry of biopsy specimen may facilitate accurate diagnosis before resection. Therefore, sufficient recognition of the characteristics of pancreatic hamartomas is desirable.
Collapse
Affiliation(s)
- Hokahiro Katayama
- 1st Department of Surgery, University of Fukui, 23-3 Matsuoka Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan.
| | - Kyohei Azuma
- 1st Department of Surgery, University of Fukui, 23-3 Matsuoka Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Kenji Koneri
- 1st Department of Surgery, University of Fukui, 23-3 Matsuoka Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Makoto Murakami
- 1st Department of Surgery, University of Fukui, 23-3 Matsuoka Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Yasuo Hirono
- 1st Department of Surgery, University of Fukui, 23-3 Matsuoka Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Satomi Hatta
- Department of Pathology, University of Fukui, 23-3 Matsuoka Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Yoshiaki Imamura
- Department of Pathology, University of Fukui, 23-3 Matsuoka Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Takanori Goi
- 1st Department of Surgery, University of Fukui, 23-3 Matsuoka Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| |
Collapse
|
5
|
Kato N, Sugawara M, Maeda K, Hosoya N, Motoyama T. Pyloric gland metaplasia/differentiation in multiple organ systems in a patient with Peutz-Jegher's syndrome. Pathol Int 2011; 61:369-72. [DOI: 10.1111/j.1440-1827.2011.02670.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
6
|
Affiliation(s)
- Mansour A Parsi
- The Cleveland Clinic Foundation, Department of Gastroenterology, A-31, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | | |
Collapse
|
7
|
Al-Ahmadie H, Gomez AM, Trane N, Bove KE. Giant botryoid fibroepithelial polyp of bladder with myofibroblastic stroma and cystitis cystica et glandularis. Pediatr Dev Pathol 2003; 6:179-81. [PMID: 12574920 DOI: 10.1007/s10024-002-8817-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2002] [Accepted: 10/21/2002] [Indexed: 11/27/2022]
Abstract
A 3-year-old boy presented with a single episode of gross hematuria and no history of previous urinary tract disorder. Imaging studies revealed a large complex polypoid filling defect in the bladder lumen. Several attempts at transurethral biopsy and cytological examination of the urine revealed clumps of benign epithelial cells, but suspicion of a malignant neoplasm such as rhabdomyosarcoma remained high and the lesion was resected. The specimen measured 15 cm, had a narrow zone of attachment to the bladder mucosa, and was grossly botryoid. Changes typical of cystitis cystica et glandularis were present at and near all surfaces. Myxoid stroma contained scattered benign fibroblasts, myofibroblasts, and smooth muscle cells. Inexplicably, one of two karyotyped stromal cells demonstrated a translocation usually associated with rhabdomyosarcoma. This child is well without evidence of bladder abnormality 1.5 years after surgery.
Collapse
Affiliation(s)
- Hikmat Al-Ahmadie
- Division of Pediatric Pathology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | | | | | | |
Collapse
|
8
|
Ramírez Plaza C, Rodríguez Rodríguez J, Casquero Romero S, Pérez Daga J, Fernández Aguilar J, López Rueda B, Pérez Lara F, Iaría Romero M, Iaría Romero M, Aranda Narváez J, Navarro Piñero A, de la Fuente Perucho A. Síndrome de Peutz-Jeghers. Presentación de un caso con degeneración maligna metacrónica de pólipos adenomatosos y hamartomatosos. Cir Esp 2001. [DOI: 10.1016/s0009-739x(01)71690-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
9
|
Abstract
A wide range of epithelial and mesenchymal pseudoneoplastic disorders of the urinary bladder may clinically and pathologically mimic a malignant neoplasm. These lesions usually require a tissue biopsy for definitive diagnosis. It is important to be aware of these lesions and their spectrum of morphologic appearances to avoid overdiagnosis and inappropriate aggressive therapy.
Collapse
Affiliation(s)
- E C Jones
- Department of Pathology, Vancouver General Hospital, University of British Columbia, Canada
| |
Collapse
|
10
|
Fernandez Seara MJ, Martinez Soto MI, Fernandez Lorenzo JR, Trabazo S, Gamborino E, Forteza Vila J. Peutz-Jeghers syndrome in a neonate. J Pediatr 1995; 126:965-7. [PMID: 7776109 DOI: 10.1016/s0022-3476(95)70224-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
A 15-day-old girl was found to have generalized gastrointestinal polyposis resulting from Peutz-Jeghers syndrome. Her manifestations included abdominal distention, hematemesis, bloody diarrhea, and edema. She died at 1 year of age of multiple complications of her disease.
Collapse
Affiliation(s)
- M J Fernandez Seara
- Department of Pediatrics, Hospital General de Galicia, Santiago de Compostela, Spain
| | | | | | | | | | | |
Collapse
|
11
|
|