Villous adenoma of the urachal remnant: A diagnostic conundrum

Treatment of Villous Adenoma With Underlying Adenocarcinoma of the Prostatic Urethra Using Combined Chemoradiation: A Case Report

The presence of villous adenoma in the urinary tract is an exceedingly rare finding. On a histological and cytological level, this tissue is essentially identical to that typically found in the colon. These lesions do have malignancy potential and, when present with coexistent adenocarcinoma, have a risk of recurrence and metastasis even after surgical resection. Although villous adenomas of the urinary tract have been almost exclusively treated with surgical intervention in the literature, we present a case of villous adenoma with underlying adenocarcinoma of the prostatic urethra that was successfully treated with combined chemoradiation therapy. While surgical excision has been shown to be curative in diseases with isolated villous adenoma, more aggressive treatment with radiation and/or chemotherapy can be considered in patients with concurrent adenocarcinoma. However, more research into this subject is required to properly determine the best choice of therapy for this niche patient population.

Urinary tract villous adenoma in Indonesia

This is the first recorded case of urinary tract villous adenoma in Indonesia. A 70-years-old man suffered from a painful left flank mass and jelly like mixed urine. He had undergone percutaneous nephrostomy yielding a jelly like substance, and a previous stone surgery. Left nephrectomy and lymph nodes dissection were performed. Intraoperative finding showed significant mucus fluxed from this enlarged kidney. Histopathological examination revealed columnar epithelium and goblet cells amongst the villiform glands. There is no standard established protocol for follow up and management. We should follow-up for a possibility of recurrence or progression.