Primary papilloma of the proximal ureter in a 13-year old boy: A rare case

Abstract

Introduction: Approximately 1 percent of the tumors observed in the upper urinary tract are primary tumors of the ureter. The exact diagnosis is done by a histologic study. Most cases need surgery, which is done by complete resection of the tumoral segment of the ureter.

Presentation of case: This study presents a 13-year-old boy who referred to Ali Asghar pediatric hospital with complaints of right flank pain and hematuria for four months. The ultrasonography revealed moderate-grade hydronephrosis. The retrograde urography confirmed a 1.5 cm lesion with filling defects in the proximal segment of the right ureter. The abdominal CT-scan confirmed a 1.5 cm filling defect lesion with a smooth margin in the right proximal ureter adjacent to the ureteropelvic orifice. On cystoscopy, a sessile mass developed in the proximal portion of right ureter and providing pronounced dilation of the ureter and ipsilateral hydronephrosis. Histopathology examination revealed a benign neoplasm composed of a delicate fibrovascular core covered by normal-appearing urothelium. The patient underwent a successful proximal segment resection of the ureter by surgery.

Discussion: Benign tumors of the ureter are much less frequent than malignant ones. Mostly, they involve the lower third of the ureter. Pain, hematuria, and hydronephrosis are the most clinical signs. The final diagnosis can be established with the histologic examination. The choice treatment in is segmental ureterectomy.

Conclusion: Primary ureteral papilloma is extremely rare in the child. The histopathology study is essential for ruling out malignancy. The recurrence and progression of ureteral papilloma are controversial.

Keywords: Child; Papilloma; Ureter.