Tiwari P, Tripathi A, Vijay M, Mitra B, Kumar S, Pal D K, Kundu A K
Department of Urology, IPGMER & SSKM, Kolkata, India.
Indian J Cancer. 2010 Oct-Dec;47(4):418-23. doi: 10.4103/0019-509X.73573.
Inverted papilloma (IP) is an uncommon benign neoplasm of the urinary tract. Its multiplicity, recurrence, and association with transitional cell carcinoma (TCC) leads to conflicting clinical conclusions regarding its biological behavior, and hence, the need for rigorous follow-up protocols. In this study, we review all cases of urinary bladder IP in our institution and determine the need for strict follow-up.
We included consecutive patients from August 2004 to August 2008 with IP of the urinary bladder in this study who did not have prior or concurrent urothelial carcinoma. A single pathologist performed the histologic review. The patients had undergone strict a follow-up schedule every 6 months.
In our study of the 24 patients, the mean age at presentation was 53.5 (range 22-81) years. The mean follow-up period was 25.8 months (range 6-58 months). Of the 24 patients, 21 were men and 3 were women. No patient had a synchronous or previous bladder tumor. The most common presenting symptoms were macroscopic hematuria and dysuria. All were solitary tumors except one, most commonly found at the bladder neck and trigone. The average follow-up period was 2.5 years without any evidence of recurrence.
We conclude that when diagnosed by strictly defined criteria, IP as benign urothelial neoplasm was with extremely low incidence of recurrence and good prognosis. It does not seem to be a risk factor for TCC, especially if located in the bladder. Therefore, a good transurethral resection is adequate therapy and follow-up protocol as rigorous as those for TCC may not be necessary.
内翻性乳头状瘤（IP）是一种少见的泌尿道良性肿瘤。其多发性、复发性以及与移行细胞癌（TCC）的关联导致了关于其生物学行为的临床结论相互矛盾，因此需要严格的随访方案。在本研究中，我们回顾了我院所有膀胱IP病例，并确定严格随访的必要性。
本研究纳入了2004年8月至2008年8月期间连续收治的膀胱IP患者，这些患者既往或同期均无尿路上皮癌。由一名病理学家进行组织学检查。患者每6个月接受一次严格的随访。
在我们对24例患者的研究中，就诊时的平均年龄为53.5岁（范围22 - 81岁）。平均随访期为25.8个月（范围6 - 58个月）。24例患者中，21例为男性，3例为女性。所有患者均无同步或既往膀胱肿瘤。最常见的症状是肉眼血尿和排尿困难。除1例为多发肿瘤外，其余均为单发肿瘤，最常见于膀胱颈和三角区。平均随访期为2.5年，无任何复发迹象。
我们得出结论，当按照严格定义的标准诊断时，IP作为良性尿路上皮肿瘤复发率极低且预后良好。它似乎不是TCC的危险因素，尤其是位于膀胱时。因此，经尿道切除术是充分的治疗方法，可能无需像TCC那样严格的随访方案。
