Villous adenomas of the urinary tract: report of two cases

Villous adenomas are rare tumors of the urinary tract. They are morphologically identical to their counterpart in the colon. The histogenesis and malignant potential are uncertain. We report on 2 cases, 1 each in the urethra and bladder. The first is a 57-year-old male who complained of an acute attack of urinary retention. A papillary tumor, measuring 3.0 x 2.0 cm, was found in the prostatic portion of the urethra by cystoscopy, and the tumor was removed transurethrally. The second case, a 33-year-old male, was a victim of chronic pyelonephritis with severe hydronephrosis resulting from a left renal staghorn stone. A papillary tumor was noted on the dome of the urinary bladder. The tumor, measuring 2.0 x 2.0 cm, was resected by transurethral resection. No recurrence or malignant transformation has been found during the follow-up period. The features of morphology, immunohistochemistry, and histochemistry were well studied. Staining by periodic acid-Schiff (PAS) stain, Alcian blue at pH 1.0, and Alcian blue at pH 2.5 were all positive. The carcinoembryonic antigen was strongly positive in the neoplastic glands, especially in the luminal border. We also review the previous literature and discuss the histogenesis, diagnosis, and treatment.