Fibroepithelial Polyp of Renal Pelvis

Fibroepithelial Polyp of Renal Pelvis

Article
Kidney & Bladder Health
Diseases & Conditions
+1
Contributed byMaulik P. Purohit MD MPHSep 13, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Fibroepithelial Polyp of Kidney
  • Fibroepitheloid Polyp of Renal Pelvis
  • Renal Fibroepithelial Polyp

What is Fibroepithelial Polyp of Renal Pelvis? (Definition/Background Information)

  • Fibroepithelial Polyp of Renal Pelvis is an uncommon benign tumor. The tumor is seen among a wide range of adults. It occurs more commonly in women than men, according to some studies
  • The kidney consists of 2 zones; the cortex and the medulla. The cortex is the peripheral or outer portion of the kidney, and the medulla is the central or inner portion of the kidney, where pelvis is located. The tumor is usually present in the pelvis of the kidney, but it can also arise from the ureters
  • The cause and risk factors for the formation of Fibroepithelial Polyp of Renal Pelvis tumors are not well-established. Many tumors are found incidentally while examining the individual for other medical conditions
  • The signs and symptoms depend upon the size of the tumors and it may include blood in urine, abdominal pain, and frequent infections affecting the urinary tract system. Large tumors are even known to cause chronic kidney failure
  • Typically, a surgical excision of Fibroepithelial Polyp of Renal Pelvis with its entire removal is the treatment of choice. The prognosis is excellent with its complete removal, since it is usually a benign tumor
  • However, the prognosis also depends upon a set of factors that includes the severity of the signs and symptoms and one’s response to treatment

Who gets Fibroepithelial Polyp of Renal Pelvis? (Age and Sex Distribution)

  • Fibroepithelial Polyp of Renal Pelvis is seen in wide age group of adults. However, they can be present in children too
  • Both males and females can be affected, but some reports indicate a slight female predominance
  • No specific ethnic or racial preference is seen

What are the Risk Factors for Fibroepithelial Polyp of Renal Pelvis? (Predisposing Factors)

  • Currently, no definitive risk factors have been noted for Fibroepithelial Polyp of Renal Pelvis

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes for Fibroepithelial Polyp of Renal Pelvis? (Etiology)

The exact cause and mechanism of Fibroepithelial Polyp of Renal Pelvis formation is unknown.

What are the Signs and Symptoms of Fibroepithelial Polyp of Renal Pelvis?

The signs and symptoms of Fibroepithelial Polyp of Renal Pelvis depend on the size and location of the tumor. It can also vary from one individual to another. In general, small tumors are asymptomatic and large tumors can cause signs and symptoms. The kidney symptoms may be caused due to mass effect (presence of bulky tumors).

The signs and symptoms of Fibroepithelial Polyp of Renal Pelvis may include the following:

  • The tumors can range in size from 0.5 cm to 12 cm
  • The tumor affects the medulla or central portion of the kidney (pelvis region of the kidney)
  • It may be present as an abdominal mass
  • The tumor is often well-defined and demarcated
  • It may be associated with frequent urinary tract infections, blood in urine, increased blood pressure, and flank pain
  • Large tumors can severely affect the functioning of the kidney that is involved. Tumors growing to larger sizes can cause compression of adjoining organs and structures, but are not known infiltrate into them

How is Fibroepithelial Polyp of Renal Pelvis Diagnosed?

In many cases, Fibroepithelial Polyp of Renal Pelvis is diagnosed incidentally during imaging studies undertaken for some other health conditions. The diagnosis may involve the following tests and procedures:

  • Complete physical exam with evaluation of medical history
  • Plain X-ray of the abdomen
  • Ultrasound scan of the abdomen
  • CT or CAT scan with contrast of the abdomen may show a well-defined mass. This radiological procedure creates detailed 3-dimensional images of structures inside the body
  • MRI scans of the abdomen: Magnetic resonance imaging (MRI) uses a magnetic field to create high-quality pictures of certain parts of the body, such as tissues, muscles, nerves, and bones. These high-quality pictures may reveal the presence of the tumor
  • Urine analysis to check for the presence of blood cells
  • Kidney function test
  • Intravenous pyelogram (IVP): A dye is injected into the blood vessels and the image of kidney structure is obtained
  • Vascular angiographic studies of the tumor

Invasive diagnostic procedures such as:

  • Laparoscopy: A special device is inserted through a small hole into the abdomen, to visually examine it. If necessary, a tissue sample is obtained for further analysis. Exploration of the abdomen using a laparoscope is called ‘exploratory laparoscopy’
  • Laparotomy: The abdomen is opened through an incision for examination, and if required, a biopsy sample obtained. Exploration of the abdomen using laparotomy procedure is called ‘exploratory laparotomy’

Although the above modalities can be used to make an initial diagnosis, a tissue biopsy of the tumor is necessary to make a definitive diagnosis to begin treatment. The tissue for diagnosis can be procured in multiple different ways which include:

  • Fine needle aspiration (FNA) biopsy of the kidney tumor: A FNA biopsy may not be helpful, because one may not be able to visualize the different morphological areas of the tumor. Hence, a FNA biopsy as a diagnostic tool has certain limitations, and an open surgical biopsy is preferred
  • Core biopsy of the kidney tumor
  • Open biopsy of the kidney tumor

Tissue biopsy:

  • A tissue biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
  • Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
  • Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and very rarely, electron microscopic studies to assist in the diagnosis

A differential diagnosis, to eliminate other tumor types is considered, before arriving at a conclusion.

The differential diagnosis includes:

  • Hemangioma
  • Leiomyoma
  • Schwannoma 

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Fibroepithelial Polyp of Renal Pelvis?

The complications of Fibroepithelial Polyp of Renal Pelvis may include:

  • Stress and anxiety due to a concern of kidney cancer
  • Chronic renal failure affecting kidney function, if tumors are large; especially, when the condition is bilateral (affecting both kidneys). In majority of cases, the tumor affects one kidney
  • Damage to the muscles, vital nerves, and blood vessels, during surgery
  • Post-surgical infection at the wound site is a potential complication

Research has not conclusively proven that Fibroepithelial Polyp of Renal Pelvis can turn malignant.

How is Fibroepithelial Polyp of Renal Pelvis Treated?

The treatment options vary from one individual to another. The treatment measures for Fibroepithelial Polyp of Renal Pelvis may include the following:

  • Majority of asymptomatic tumors are not surgically removed after the tumor is determined to be benign on a biopsy: The healthcare provider may recommend a ‘wait and watch’ approach for small-sized tumors presenting mild signs and symptoms, after a diagnosis of Fibroepithelial Polyp of Kidney is made, through a fine needle aspiration or a core biopsy
  • Surgical intervention with complete excision can result in a cure. It can also help reduce the chances of tumor recurrence

The surgical treatment methods for Fibroepithelial Polyp of Renal Pelvis may include:

  • Endoscopic surgery
  • Nephron-sparing surgery
  • Partial or complete nephrectomy
  • Tumor embolization is a possible treatment option. Here the blood supply to the tumor is blocked resulting in its shrinkage or death

A partial or complete nephrectomy may be considered, when large-sized tumors are noted in the kidneys. 

  • A kidney dialysis may be required, if the kidney function is severely compromised due to renal failure
  • Postoperative care is important: A minimum activity level is ensured, until the surgical wound heals
  • Follow-up care with regular screening may be recommended by the healthcare provider

How can Fibroepithelial Polyp of Renal Pelvis be Prevented?

  • Current medical research has not established a method of preventing Fibroepithelial Polyp of Renal Pelvis
  • Regular medical screening at periodic intervals with tests and physical examinations are strongly recommended

What is the Prognosis of Fibroepithelial Polyp of Renal Pelvis? (Outcomes/Resolutions)

The prognosis of Fibroepithelial Polyp of Renal Pelvis depends upon the severity of the signs and symptoms. It also depends upon the overall health of the individual.

  • Typically, individuals with small-sized tumors have a better prognosis than those with larger-sized tumors
  • In most cases, the prognosis of small-sized solitary tumors is excellent with surgical intervention or appropriate treatment, since these are benign

Additional and Relevant Useful Information for Fibroepithelial Polyp of Renal Pelvis:

Please visit our Cancer & Benign Tumors Health Center for more physician-approved health information:

http://www.dovemed.com/diseases-conditions/cancer/

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Maulik P. Purohit MD MPH picture
Approved by

Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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