Nephrogenic adenoma of the renal pelvis

Nephrogenic adenoma of the renal pelvis: A rare case report and review of the literature

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.

A case series of nephrogenic adenoma of the urethra and bladder in children: review of this rare diagnosis, its natural history and management, with reference to the literature

Nephrogenic adenoma (NA) is a rare benign tumour of the urinary tract and is found most commonly in the bladder. Here are presented four cases of paediatric NA, two bladder and two urethral. Their diagnostic and management features in the context of differential diagnosis and natural history are discussed. A 3-year-old girl presented with recurrent urinary tract infections (UTIs) and haematuria. She had undergone a previous hemi-nephro-ureterectomy. An ultrasound scan suggested a large bladder tumour, which was biopsied cystoscopically, and histology confirmed an NA. She then underwent open resection of the tumour. A 4-year-old girl presented with recurrent UTIs and a history of previous bilateral duplex ureterostomies and subsequent trans-uretero-ureterostomy with ureteric re-implantation. A cystoscopy showed a papillary tumour, which was confirmed as NA on histology. An 11-year-old boy presented with haematuria and dysuria and no other relevant history. At urethroscopy a ragged area biopsied in the bulbar urethra showed NA. A 7-year-old boy presented with haematuria and no other relevant history. At urethroscopy an inflamed nodular area was biopsied and nephrogenic adenoma confirmed. In the two bladder cases, but not the urethral cases, a causative factor could be identified. Recurrence was noted in both of the bladder cases. The urethral cases had persistent symptoms suggestive of continuing NA. Treatment consisted of endoscopic and open ablation of the tumours, and endoscopic fulguration of recurrences for the bladder cases, and surveillance for the urethral cases. Only two previous cases of urethral and 25 cases of bladder NA have been reported in children.