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Polypoid arteriovenous malformation of the ureter mimicking a fibroepithelial polyp, a case report
C S Ten Donkelaar1, A C Houwert2, F J W Ten Kate2
1University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. C.S.tenDonkelaar-2@umcutrecht.nl.
Background:
Arteriovenous malformations (AVM) of the urinary tract are extremely rare. To the best of our knowledge, only three case of AVM of the ureter have been described in the literature so far.
Case Presentation:
We present an additional, fourth case of an AVM of the ureter, clinically presented as asymptomatic haematuria and an obstructive process in the left ureter. Ureteroscopic evaluation revealed a fibroepithelial polypoid-like lesion in the proximal ureter. After biopsy showed a benign lesion, the lesion was treated with the 2-μm continuous wave (cw) thulium laser. Histopathological examination revealed a polypoid laesion caused by a circumscribed arteriovenous malformation. Almost four years after operation the patient remains asymptomatic and free of recurrence.
Conclusion:
Arteriovenous malformations of the urinary tract are extremely rare. We presented a fourth case of a arteriovenous malformation of the ureter.
Insights
Arteriovenous malformations (AVM) of the ureter are exceptionally rare, with only four cases reported. This study details a successful laser treatment for a ureteral AVM presenting as hematuria and obstruction.
Area of Science:
- Urology
- Vascular Surgery
- Medical Diagnostics
Background:
- Arteriovenous malformations (AVM) of the urinary tract are exceedingly rare vascular anomalies.
- Literature review indicates only three previously documented cases of ureteral AVMs.
Observation:
- A fourth case of ureteral AVM is presented, initially appearing as asymptomatic hematuria and left ureteral obstruction.
- Ureteroscopic examination identified a fibroepithelial polypoid-like lesion in the proximal ureter.
- Initial biopsy suggested a benign lesion, leading to treatment with a 2-μm continuous wave (cw) thulium laser.
Findings:
- Histopathological examination confirmed the lesion was a circumscribed arteriovenous malformation.
- The patient remained asymptomatic and showed no recurrence nearly four years post-treatment.
Implications:
- This case expands the understanding of rare ureteral AVM presentations and management.
- Successful endoscopic laser ablation offers a minimally invasive treatment option for ureteral AVMs.
- Further research into the etiology and optimal treatment strategies for these rare conditions is warranted.
