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CASE REPORT
Year : 2000  |  Volume : 17  |  Issue : 1  |  Page : 47-48
 

Polypoid cystitis with pachydermoperio­stosis: An unusual association


Department of Urology, Kasturba Medical College, Manipal, India

Correspondence Address:
K Sasidharan
Department of Urology, Kasturba Medical College, Manipal - 576 119
India
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Source of Support: None, Conflict of Interest: None


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Keywords: Polypoid Cystitis, Pachydermoperiostosis.


How to cite this article:
Ramesh K, Parasher R, Sasidharan K. Polypoid cystitis with pachydermoperio­stosis: An unusual association. Indian J Urol 2000;17:47-8

How to cite this URL:
Ramesh K, Parasher R, Sasidharan K. Polypoid cystitis with pachydermoperio­stosis: An unusual association. Indian J Urol [serial online] 2000 [cited 2019 Jun 17];17:47-8. Available from: http://www.indianjurol.com/text.asp?2000/17/1/47/41014



   Introduction Top


Mr. SC, a 22-year-old male presented to Urology serv­ices of Kasturba Hospital, Manipal, with haematuria, irri­tative and obstructive voiding and pain in the calf muscles.

He was found to have clubbing of hands and x-rays confirmed pachydermoperiostosis [Figure 1]a & b.

Ultrasound KUB region revealed a growth in the tri­gone, extending into both the lateral walls of the urinary bladder and normal kidneys.

Excretory urography done at the time of presentation confirmed the same finding. Cystoscopy showed a polypoid mass of 4 x 3 cm occupying the trigone and part of lateral walls. Ureteric orifices were found to be nor­mal. Bidigital examination showed no induration. Resec­tion biopsy of the polypoid mass revealed polypoid cystitis [Figure 2]b.

Postoperatively, the patient remained well for a period of 3 months, after which he started having recurrence of his previous symptoms and identical lesions in the blad­der, along with left hydroureteronephrosis documented on follow-up excretory urogram and CT scan of the abdo­men [Figure 2]a. He underwent multiple resections of the vesical lesions during this period, and subsequently a left ureteric reimplantation. Patient became asymptomatic fol­lowing these procedures and continues to remain so till now.


   Comments Top


Polypoid cystitis is a benign lesion involving the lamina propria of the urinary bladder. It is associated with stro­mal oedema, congestion with scanty inflammation. There are stellate mononuclear or multinucleated fibroblasts, with no atypia. [3]

It has been frequently reported in patients with some inciting cause such as indwelling catheter, trauma, uri­nary obstruction, [2] malignancy, vesicointestinal fistula or radiation. [3] But there has been no report of polypoid cysti­tis in the absence of any inciting cause.

It has a benign and protracted course and is associated with fibrosis, [2] as seen in the present case, resulting in left hydroureteronephrosis.

Pachydermoperiostosis clinically can be characterized by clubbing and vague pains in joints and bones, with X-­ray evidence of cortical thickening of bones, as seen in this case. [1] This case is also reported, as it is first of its kind in literature, to be associated with pachydermoperio­stosis.

 
   References Top

1.Resnick D. Enostosis, Hyperostosis and Periostosis. In: Resnick D (ed.). Diagnosis of bone and joint disorders (3''ed.). Philadelphia: Saunders. 1995: 4421-4427.  Back to cited text no. 1    
2.Buck EG. Polypoid cystitis mimicking transitional cell carcinoma. J Urol 1984: 131: 963.  Back to cited text no. 2    
3.Robert HY. Non-neoplastic epithelial abnormalities and tumour like lesions. In: Robert HY (ed.). Pathology of the urinary bladder. Ed­inburgh: Churchill Livingstone, 1989: 19-20.  Back to cited text no. 3    


    Figures

  [Figure 1], [Figure 2]



 

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