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Ureteral Fibroepithelial Polyp

Last updated July 23, 2019

Approved by: Krish Tangella MD, MBA, FCAP

Ureteral Fibroepithelial Polyp is an uncommon benign tumor that affects the ureter. The ureters are a pair of tubes that carry urine from the kidneys to the urinary bladder. The tumor is seen among a wide range of adults and children.


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

  • Fibroepithelial Polyp of Ureter

What is Ureteral Fibroepithelial Polyp? (Definition/Background Information)

  • Ureteral Fibroepithelial Polyp is an uncommon benign tumor that affects the ureter. The ureters are a pair of tubes that carry urine from the kidneys to the urinary bladder. The tumor is seen among a wide range of adults and children
  • The cause of Ureteral Fibroepithelial Polyp is unknown, but the contributory factors include the presence of kidney stones, any surgical procedure that leads to irritation of the ureter, and frequent bladder infections
  • The signs and symptoms depend upon the size of the tumors and it may include blood in urine, abdominal pain, and urination difficulties. Large tumors may completely block the ureter and lead to additional complications
  • Generally, a surgical excision of Ureteral Fibroepithelial Polyp with its entire removal is the treatment of choice. The prognosis is excellent with its complete removal, since it is typically a benign tumor

Who gets Ureteral Fibroepithelial Polyp? (Age and Sex Distribution)

  • Ureteral Fibroepithelial Polyp is seen in wide age group of both children and adults. However, the peak age range is between 20-40 years
  • Both males and females can be affected, though a slight male predilection is noted (male-female ratio is 3:2)
  • No specific ethnic or racial preference is seen

What are the Risk Factors for Ureteral Fibroepithelial Polyp? (Predisposing Factors)

The following risk factors have been noted for Ureteral Fibroepithelial Polyp:

  • Kidney stones
  • Frequent ureteral and bladder infections
  • Past procedures involving surgical instruments in the ureter (causing trauma in the region) may be a risk factor

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 of Ureteral Fibroepithelial Polyp? (Etiology)

  • The exact cause and mechanism of Ureteral Fibroepithelial Polyp formation is unknown
  • However, some researchers believe that the tumor may originate from congenital remnants. Others believe, that it is a reactive process caused due to irritation of the ureters

What are the Signs and Symptoms of Ureteral Fibroepithelial Polyp?

The signs and symptoms of Ureteral Fibroepithelial Polyp can vary from one individual to another. In general, small tumors are asymptomatic and large tumors can cause signs and symptoms, usually due to obstruction.

The signs and symptoms may include the following:

  • Difficulty in urination
  • Blood in urine
  • Frequent abdominal pain
  • Most tumors are small, while some are large enough to completely obstruct the ureter (and affect the passage of urine to the bladder)
  • The tumors can range in size from less than 1 cm, to about 12 cm
  • Obstruction of ureter can lead to frequent bladder infections
  • For some reason the tumor is often seen in the left ureter more than the right ureter
  • The polyps are usually single; but sometimes multiple and even bilateral tumors have been observed
  • 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 Ureteral Fibroepithelial Polyp Diagnosed?

The diagnosis of Ureteral Fibroepithelial Polyp 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 and kidneys
  • CT scan of the kidney and abdomen
  • Intravenous urography, where a dye is injected into the blood vessels and the image of ureters, kidney, etc. is obtained
  • Retrograde pyelography: The use of X-rays to visualize the kidneys, ureter, and other abdominal structures
  • Cystoscopy to rule out bladder tumors
  • Ureteroscopy with tissue biopsy is considered to be the gold standard for arriving at a definitive diagnosis of the tumor
  • Urine analysis to check for the presence of blood cells
  • Kidney function test
  • 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 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 tumor
  • Open biopsy of the 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 and conditions is considered, before arriving at a conclusion. The differential diagnosis includes:

  • Transitional cell carcinoma
  • Parasitic infections
  • Blood clots
  • Fungal infection causing fungal boils

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 Lipoma of Kidney?

The complications of Ureteral Fibroepithelial Polyp may include:

  • Stress and anxiety due to a concern of cancer
  • Ureteral stricture
  • Obstruction of the ureter may lead to obstructive hydronephrosis
  • Rarely, tumor recurs after surgery
  • Malignant transformation of the tumor is known to occur in rare cases
  • Post-surgical infection at the wound site is a potential complication

How is Ureteral Fibroepithelial Polyp Treated?

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

  • Surgical intervention with complete excision can result in a cure. It can also help reduce the chances of tumor recurrence
  • Laser endoscopic procedure - using laser to remove the tumor
  • Occasionally, stent placement in the ureter may be necessary, to prevent ureteral stricture (narrowing of the ureter)
  • 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 Ureteral Fibroepithelial Polyp be Prevented?

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

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

  • The prognosis of Ureteral Fibroepithelial Polyp depends upon the severity of the signs and symptoms. It also depends upon the overall health of the individual.
  • In most cases, the prognosis of the condition is excellent with surgical intervention or appropriate treatment, since these are benign

Additional and Relevant Useful Information for Ureteral Fibroepithelial Polyp:

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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Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: April 30, 2017
Last updated: July 23, 2019