Bladder Exstrophy Polyp: An Uncommon Entity in Surgical Pathology

Background: Bladder exstrophy is a congenital malformation occurring more commonly in males. The occurrence of polyps in these bladders represents a well-known phenomenon to the treating urologist. However, they might not be as familiar to pathologists since they are generally not biopsied. Case report: We present a male infant who was diagnosed with bladder exstrophy and epispadias at birth. He subsequently underwent surgical repair of the malformation with bladder polypectomies at 7 months of age. Pathologic examination showed multiple polyps with extensive squamous metaplasia of surface urothelium. Von Brunn nests, cystitis cystica, and cystitis glandularis with focal intestinal metaplasia were noted at variable depths within polyps. These epithelial nests were surrounded by concentric fibrosis. Conclusion: Bladder exstrophy polyp is a distinct pathologic entity with a combination of various nonspecific findings. Pathologists should be cognizant of the histologic spectrum of this uncommon entity.