Endoscopic treatment of a giant fibroepithelial polyp of the ureter

Fibroepithelial polyps are benign mesenchymal tumors with a morphology and clinical presentation very similar to transitional cell carcinomas, so that differential diagnosis is of paramount importance.

We present the case of a 42-year-old female patient, with history of mediastinal Hodgkin/s lymphoma, which came to the office reporting right low back colic pain and haematuria. CT scan showed pediculated neoformation of about 10 cm protruding into the bladder, with negative urine cytology. In view of the findings, and with the suspicion of fibroepithelial polyp, an endoscopic exploration was performed, confirming the diagnosis, followed by exeresis with Holmium laser.

A differential diagnosis between fibroepithelial polyp and transitional cell carcinoma cannot be made with imaging tests alone. The suspicion must be established, and endoscopic exploration indicated, by means of ureterorenoscopy or percutaneous nephroureteroscopy, whatever is a better indication, with biopsy or definitive endoscopic treatment of the tumor.

Endoscopic exploration is currently the procedure of choice for the diagnostic confirmation of this condition and its definitive treatment.