ABSTRACT
El papiloma urotelial vesical es un tumor benigno poco común, que predomina en el sexo masculino y que se presenta, más frecuentemente, en niños y en personas jóvenes. Objetivo: presentar un nuevo caso de papiloma urotelial vesical así como aspectos de su diagnóstico y tratamiento. Caso clínico: paciente del sexo masculino de 20 años de edad que asiste a la Consulta de Urología por presentar hematuria macroscópica de 3 días de evolución. Al interrogatorio se precisó que esta era terminal, monosintomática y no se acompañaba de coágulos; el examen físico resultó normal. Se le realizó ultrasonido abdominal en el que se constató la existencia de una lesión tumoral ecogénica de contornos irregulares, en proyección del fondo vesical y hacia el lateral derecho. Se practicó la cistoscopia en la cual se confirmó el tumor antes descrito, y se realizó la resección transuretral de la lesión sin complicaciones. El informe anátomo-patológico de la pieza quirúrgica fue papiloma urotelial. El paciente ha evolucionado satisfactoriamente y, en los controles semestral y anual efectuados, se encontraba asintomático y con ultrasonido y cistoscopia negativos de recidiva tumoral. Conclusiones: el papiloma urotelial vesical constituye una causa infrecuente de hematuria, y la resección transuretral una opción de tratamiento segura y eficaz. Es necesario establecer el diagnóstico histopatológico diferencial con otras lesiones neoplásicas uroteliales no invasivas, dado que existen particularidades en cuanto a recurrencia, progresión y manejo de estos tumores...
Urothelial papillomas of the bladder are uncommon benign tumors predominantly occurring in male children and young adults. Objective: present a new case of urothelial papilloma of the bladder as well as aspects of its diagnosis and treatment. Clinical case: male patient aged 20 presenting at urology consultation with macroscopic hematuria of three days' evolution. Interrogation revealed that the latter was terminal, monosymptomatic and was not accompanied by clots. The physical examination was normal. Abdominal ultrasonography revealed the presence of an echogenic tumoral lesion of irregular contour projecting from the bladder bottom toward the right side. Cystoscopy confirmed the presence of the tumor described above. Transurethral resection of the lesion was performed without any complications. The anatomo-pathological report identifies the surgical piece as an urothelial papilloma. The patient's evolution has been satisfactory. In semiannual and annual checkups he has been found to be asymptomatic. Ultrasonographic and cystoscopic examination has shown no evidence of tumor recurrence. Conclusions: urothelial papillomas of the bladder rarely cause hematuria. Transurethral resection is a safe, effective treatment option. It is necessary to establish a differential histopathological diagnosis with respect to other non-invasive neoplastic urothelial lesions, given the particular recurrence features, progression and management of these tumors...
ABSTRACT
Papiloma urotelial é raro em pacientes na infância, sendo mais comum em pacientes na sua sexta ou sétima década de vida. Comumente é indolor, sendo os sinais mais frequentes: hematúria, sintomas irritativos durante a micção, retenção urinária. O diagnóstico é realizado a partir de cistoscopia e anatomopatologia. No caso L.A.V, masculino, 10 anos, chegou ao pronto-socorro com dor de baixo-ventre, de forte intensidade, tipo cólica, não apresentando outros sintomas associados. Realizou-se um ultrassom de abdome, que evidenciou uma lesão sólida única, vegetante em base medindo 15 milímetros, lobulada e bem delimitada. O parcial de urina foi negativo para hematúria. Depois de realizada uma cistoscopia com retirada da lesão, a análise anatomopatológica diagnosticou o papiloma urotelial. O tratamento da lesão foi realizado com a sua retirada durante a cistoscopia com sucesso. Papiloma urotelial na infância tem baixa taxa de mutação e recidiva, portanto há um ótimo prognóstico para o paciente
Urothelial papilloma is rare in patients in childhood and is more common in patients in their sixth or seventh decade of life. Commonly it is painless, being the most frequent symptoms: hematuria, irritative symptoms during urination, urinary retention. The diagnosis is made from cystoscopy and pathology. In case LAV, male, 10 years, came to the emergency room with lower abdominal pain, high intensity, cramping, showing no other symptoms. We conducted an abdomen ultrasound which showed a solid lesion only vegetating in base measuring 15 mm, lobulated and well-defined. The partial urine was negative for hematuria. After a cystoscopy performed with removal of the lesion, the histopathological analysis diagnosed urothelial papilloma. The treatment of the lesion was performed with the withdrawal successfully during cystoscopy. Urothelial papilloma in childhood have low mutation rate and recurrence, so getting a good prognosis for the patient.