Recurrent Villous Adenoma with High-Grade Dysplasia Arising in a Urethral Diverticulum

Villous adenomas of the urinary tract are an uncommon, well-recognized entity, described in different locations. However, the occurrence of this lesion in the female urethral diverticulum is very unusual. We present the first case of a recurrent villous adenoma with high-grade dysplasia unassociated with adenocarcinoma, arising from a urethral diverticulum. A 75-year-old African-American female presented with urethral prolapse complaining of mild voiding difficulty, stress incontinence, and mild spotting of blood. Histological examination revealed a papillary lesion with finger-like processes lined by pseudostratified columnar epithelium with abundant goblet cells. There were focal areas with stratification to the luminal surface and loss of nuclear polarity and atypical mitoses, interpreted as villous adenoma with high-grade dysplasia. The lesion recurred at one year without evidence of malignant transformation. We also present a brief literature review of urothelial villous adenomas.

Download Full-text

A case of urachal villous adenoma with high grade dysplasia focally bordering on adenocarcinoma in situ

Urology Case Reports ◽

10.1016/j.eucr.2017.10.002 ◽

2018 ◽

Vol 16 ◽

pp. 25-28

Author(s):

Sriharsha Talluri ◽

Waleed Eisa ◽

Renee Frank ◽

Heinric Williams

Keyword(s):

Villous Adenoma ◽

High Grade Dysplasia ◽

Adenocarcinoma In Situ ◽

High Grade

Download Full-text

Villous Adenoma with High-Grade Dysplasia of the Appendix: A Case Report

Turkish Journal of Colorectal Disease ◽

10.4274/tjcd.50103 ◽

2018 ◽

Vol 28 (4) ◽

pp. 200-202

Author(s):

Birgül Tok ◽

Duygu Demiriz Gülmez ◽

Mehmet Gülmez

Keyword(s):

Case Report ◽

Villous Adenoma ◽

High Grade Dysplasia ◽

High Grade

Download Full-text

A case of ectopic pancreas of the stomach accompanied by intraductal papillary mucinous neoplasm with GNAS mutation

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02424-x ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Naoko Nambu ◽

Takashi Yamasaki ◽

Nami Nakagomi ◽

Tsutomu Kumamoto ◽

Tatsuro Nakamura ◽

...

Keyword(s):

Epigastric Pain ◽

English Literature ◽

Japanese Woman ◽

High Grade Dysplasia ◽

Ectopic Pancreas ◽

Resected Specimen ◽

Upper Gastrointestinal Endoscopy ◽

High Grade ◽

First Case ◽

Gnas Mutation

Abstract Background Ectopic pancreas is basically a benign disease and is not always necessary to be removed. However, all types of neoplasms occurring in the normal pancreas such as ductal adenocarcinomas and intraductal papillary mucinous neoplasms (IPMNs) may develop even within ectopic pancreas. We recently encountered an extremely rare case of ectopic pancreas in the gastric antrum associated with IPMN possessing a GNAS mutation. Case presentation A 71-year-old Japanese woman complained of epigastric pain. Computed tomography and upper gastrointestinal endoscopy showed an intramural cystic mass in the antrum of the stomach. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) biopsy did not give a definitive diagnosis, and the patient underwent resection of the lesion. Histology of the resected specimen showed that the gastric intramural lesion was ectopic pancreas. Moreover, the lesion contained dilated duct components with tubulo-villous epithelial proliferation consistent with pancreatic IPMN. Since the covering epithelial cells had highly atypical nuclei, the lesion was diagnosed as IPMN with high grade dysplasia. Immunohistochemistry showed that the IPMN component showed to be MUC2-, MUC5AC-, and CDX2-positive but MUC1- and MUC6-negative. Mutational analyses using genomic DNA revealed that the IPMN component had a mutation of GNAS at exon 8 (Arg201Cys). Conclusion We finally diagnosed this case as gastric ectopic pancreas accompanied by intestinal type IPMN with high grade dysplasia possessing GNAS mutation. Although there were 17 cases of ectopic pancreas with IPMN including 6 cases of gastric ones reported in the English literature, this is the first case of ectopic pancreas with IPMN which was proved to have GNAS mutation. Intimate preoperative examinations including imaging analyses and EUS-FNA biopsy/cytology are recommended to decide whether the lesion has to be resected or not even if they are not effective for getting the right diagnosis.

Download Full-text

Tubular adenoma with high-grade dysplasia in the ileal segment 34 years after augmentation ileocystoplasty: report of a first case

Diagnostic Pathology ◽

10.1186/1746-1596-2-29 ◽

2007 ◽

Vol 2 (1) ◽

pp. 29 ◽

Cited By ~ 5

Author(s):

Henry B Armah ◽

Alyssa M Krasinskas ◽

Anil V Parwani

Keyword(s):

High Grade Dysplasia ◽

Tubular Adenoma ◽

High Grade ◽

Ileal Segment ◽

First Case

Download Full-text

Successful endoscopic treatment of intraductal extension of a villous adenoma with high-grade dysplasia, with 3-year follow-up

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2010.11.020 ◽

2011 ◽

Vol 74 (3) ◽

pp. 714-716 ◽

Cited By ~ 6

Author(s):

Atif Saleem ◽

Kenneth K. Wang ◽

Todd H. Baron

Keyword(s):

Endoscopic Treatment ◽

Villous Adenoma ◽

High Grade Dysplasia ◽

High Grade ◽

Intraductal Extension

Download Full-text

Intestinal type villous adenoma of the renal pelvis

Canadian Urological Association Journal ◽

10.5489/cuaj.257 ◽

2013 ◽

Vol 7 (1-2) ◽

pp. 138 ◽

Cited By ~ 6

Author(s):

Jill Hudson ◽

Thomas Arnason ◽

Jennifer L.O. Merrimen ◽

Joseph Lawen

Keyword(s):

Renal Pelvis ◽

Villous Adenoma ◽

Renal Mass ◽

Intestinal Type ◽

High Grade ◽

Histopathologic Examination ◽

Computed Tomography Scan ◽

Invasive Adenocarcinoma ◽

Tomography Scan ◽

Villous Adenomas

Intestinal type villous adenomas are uncommon in the genitourinary tract. Most reported cases have been located in the urinary bladder or urachus. Villous adenoma arising in the renal pelvis or ureteris very rare. We present a case of an 81-year-old female who presented with difficulty voiding and mucosuria. A computed tomography scan identified right-sided hydronephrosis, renal parenchymal atrophy, nonobstructing calculi and a lower pole renal mass. She underwent open right nephrectomy. Histopathologic examination of the kidney revealed an intestinal type villous adenoma of the renal pelvis with high-grade dysplasia and focal areas suspicious for invasive adenocarcinoma. We review the four previously reported cases of intestinal type villous adenoma in the renal pelvis and discuss diagnosis and management of this unusual neoplasm.

Download Full-text