Inverted urothelial papilloma –⁠ a benign lesion with a potential link to urothelial carcinoma

Overview

Major statement: The study presents a case report of an inverted urothelial papilloma, discussing its clinical manifestations, diagnosis, and treatment. It emphasizes the importance of properly obtained histology, complete resection, and considering regular follow-up due to its potential association with urothelial carcinoma.

Inverted urothelial papilloma (IUP) represents a rare benign neoplasm of the urothelium, characterized predominantly by an endophytic growth pattern and most commonly located in the urinary bladder. Clinical manifestations are nonspecific, and the lesion is often diagnosed incidentally. Although IUP has historically been considered entirely benign, some studies suggest a possible association with urothelial carcinoma, raising questions regarding its biological behavior and the need for long-term patient follow-up. We report caseof a 59-year-old male with lower urinary tract symptoms, in whom cystoscopy revealed a papillary lesion at the bladder neck. Magnetic resonance imaging demonstrated a solid lesion protruding into the bladder lumen. The patient underwent transurethral resection, and histopathological examination confirmed the diagnosis of IUP. The postoperative course was uneventful, and follow-up cystoscopy showed a normal finding. The article further summarizes current knowledge on the etiology, pathogenesis, diagnosis, differential diagnosis, treatment, and prognosis of IUP based on available literature. Although the risk of recurrence is low, considering the potential association with urothelial carcinoma, regular follow-up should be considered, particularly during the first years postoperatively.

Keywords:

urinary bladder neoplasm – inverted papilloma – urinary bladder – risk factor – follow-up studies