Fibroepithelial polyps of the urinary tract

Fibroepithelial polyps of the urothelium are rare but frequently mistaken for transitional cell carcinoma. To better define the demographics, urothelial distribution, and typical gross anatomic and radiologic appearances, we reviewed 41 pathologically proven cases.

We reviewed 41 cases of fibroepithelial polyps from the archives of the Armed Forces of Pathology. Data were collected from radiographic studies, gross anatomic pathology, and pathology and radiology reports and categorized by age, sex, clinical presentation, lesion size, location, and morphology.

The mean patient age was 21 years, and 58% were male. Most presented with hematuria and/or flank pain (68%). Most polyps were located in the upper ureter or renal pelvis (87%). Posterior urethral and bladder polyps were present in children. Most polyps were single or bilobed (73%) and 1-6 cm.

Because most urothelial tumors are malignant epithelial tumors, fibroepithelial polyps are commonly mistaken for transitional cell carcinomas. However, because fibroepithelial polyps and malignant urothelial tumors typically present in different patient populations, different locations in the urinary tract, and appear different radiographically, distinguishing features between these entities is helpful in determining the differential diagnosis of a urothelial mass. In the appropriate clinical setting, fibroepithelial polyps should be considered in the differential diagnosis, which will affect surgical treatment.