J Korean Med Sci.  2010 Apr;25(4):644-646. 10.3346/jkms.2010.25.4.644.

Multiple, Bilateral Fibroepithelial Polyps Causing Acute Renal Failure in a Gastric Cancer Patient

• Kim SO
• Youn CW
• Kang TW
• Im CM
• Jung SI
• Oh KJ
• Kwon D
• Park K
• Ryu SB

• KMID: 1792941
• DOI: http://doi.org/10.3346/jkms.2010.25.4.644

Abstract

We report a case of primary fibroepithelial polyps (FEPs) in the middle of both ureters in a patient with advanced gastric cancer and acute renal failure. Ureteral FEPs are rare benign lesions, and multiple, bilateral lesions are extremely rare. To our knowledge, this report is the seventh case of bilateral FEPs in the literature. Our case has clinical implications because FEPs should be considered as a cause of ureteral obstruction inducing acute renal failure in advanced gastric cancer.

Keyword

Neoplasms, Fibroepithelial; Polyp; Ureter

MeSH Terms

Acute Kidney Injury/*etiology
Aged
Humans
Male
Neoplasms, Fibroepithelial/*pathology
*Polyps/complications/pathology
Stomach Neoplasms/*pathology
Ureteral Neoplasms/*pathology
Ureteral Obstruction/*pathology

Figure

• 

  Fig. 1 Radiologic images. (A) Antegrade pyelography through the nephrostomy catheter. The antegrade pyleograms revealed moderate dilatation in both renal pelvises and upper ureters, and the mid to lower ureter could not be visualized, even after 1 hr, implying complete ureter obstruction. (B) Retrograde ureterogram showing a long segmental filling defect in the upper to middle ureter corresponding to the fibroepithelial polyps.

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  Fig. 2 In situ visualization of small, multiple fibroepithelial polyps in the ureter. The ureteroscopic evaluation showed over 20 small, separate FEPs from the middle to upper ureters bilaterally.

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  Fig. 3 Histologic preparation of a fibroepithelial polyp. The stroma of fibroepithelial polyp is covered by a layer of normal transitional epithelial cells (H&E stain, ×200).

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