Abstract

Case Presentation

Not Every Bladder Mass Is Malignant: A Case of Inverted Urothelial Papilloma in a Young Adult

Mohammed Amine Elafari*, Mamad Ayoub, Mohammed Amine Bibat, Amine Slaoui, Tarik Karmouni, Abdelatif Koutani and Khalid Elkhader

Published: 30 March, 2026 | Volume 10 - Issue 1 | Pages: 016-019

Inverted Urothelial Papilloma (IUP) is an unusual variety of urothelial tumors that typically occurs in adults, with a predominance in males. The definitive diagnosis of IUP relies on histopathological examination, as the clinical presentation and endoscopic appearance are non-specific. The recommended treatment for IUP includes the complete transurethral resection, with some controversy regarding the need for cystoscopic follow-up. In this case, we present an atypical instance of IUP in a 21-year-old male patient, diagnosed with gross hematuria and irritative lower urinary tract symptoms. A clinical assessment revealed a 3.0 × 2.6 cm intravesical mass. The definitive diagnosis was confirmed histopathologically and further substantiated by immunohistochemistry, which demonstrated low expression of p53 and Ki-67, effectively ruling out malignancy. This case underscores the diagnostic challenges posed by bladder masses in young adults, emphasizing the necessity of integrating morphological and immunohistochemical findings to prevent overdiagnosis of urothelial carcinoma. The paper focuses on the diagnostic approach and management of this rare condition in the young male population.

Read Full Article HTML DOI: 10.29328/journal.jcmei.1001043 Cite this Article Read Full Article PDF

Keywords:

Inverted urothelial papilloma; Bladder tumor; Differential diagnosis; Immunohistochemistry; Young adult

References

  1. Kitahama K, Inamura K. Inverted urothelial papilloma: Diagnostic challenges, molecular insights, and clinical implications. Histol Histopathol. 2026 Mar 10:25058. Epub ahead of print. PMID: 41804641. Available from: https://doi.org/10.14670/hh-25-058
  2. Picozzi S, Casellato S, Bozzini G, Ratti D, Macchi A, Rubino B, et al. Inverted papilloma of the bladder: A review and an analysis of the recent literature of 365 patients. Urol Oncol. 2013;31(8):1584-90. Available from: https://doi.org/10.1016/j.urolonc.2012.03.009
  3. Sung MT, Maclennan GT, Lopez-Beltran A, Montironi R, Cheng L. Natural history of urothelial inverted papilloma. Cancer. 2006;107(11):2622-7. Available from: https://doi.org/10.1002/cncr.22311
  4. Patel P, Reikie BA, Maxwell JP, Yilmaz A, Gotto GT, Trpkov K. Long-term clinical outcome of inverted urothelial papilloma including cases with focal papillary pattern: Is continuous surveillance necessary? Urology. 2013;82(4):857-60. Available from: https://doi.org/10.1016/j.urology.2013.06.040
  5. Kitahama K, Shigematsu Y, Amori G, Sugawara E, Yonese J, Shibahara J, et al. RAS family gene mutations, clinicopathological features, and spread patterns of inverted urothelial papilloma of the bladder. Am J Surg Pathol. 2024;48(4):458-464. Available from: https://doi.org/10.1097/pas.0000000000002171
  6. Isharwal S, Hu W, Sarungbam J, Chen YB, Gopalan A, Fine SW, et al. Genomic landscape of inverted urothelial papilloma and urothelial papilloma of the bladder. J Pathol. 2019;248(3):260-265. Available from: https://doi.org/10.1002/path.5261
  7. Sun JJ, Wu Y, Lu YM, Zhang HZ, Wang T, Yang XQ, et al. Immunohistochemistry and fluorescence in situ hybridization can inform the differential diagnosis of low-grade noninvasive urothelial carcinoma with an inverted growth pattern and inverted urothelial papilloma. PLoS One. 2015;10(7):e0133530. Available from: https://doi.org/10.1371/journal.pone.0133530
  8. Jones TD, Zhang S, Lopez-Beltran A, Eble JN, Sung MT, MacLennan GT, et al. Urothelial carcinoma with an inverted growth pattern can be distinguished from inverted papilloma by fluorescence in situ hybridization, immunohistochemistry, and morphologic analysis. Am J Surg Pathol. 2007;31(12):1861-1867. Available from: https://doi.org/10.1097/pas.0b013e318060cb9d
  9. Liu Z, Wei S, Tang J. Clinicopathologic features of noninvasive inverted urothelial tumor. Am J Clin Oncol. 2023;46(9):409-413. Available from: https://doi.org/10.1097/coc.0000000000001027

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