Inverted papilloma of the upper urinary tract

Inverted papillomas of the upper urinary tract are rare lesions that have a male predominance. The associated symptoms are similar to those of other urothelial neoplasms. The tumors are considered benign and local excision has been advocated by many but long-term followup is lacking. We present a case of a locally excised inverted papilloma of the renal pelvis with a 3.5-year followup. While local excision appears to be ideal treatment, the difficulty with preoperative diagnosis and the reported coexistence of malignancy demand careful patient selection and close long-term followup. The biological potential of recurrence, multicentricity and malignancy is addressed.