|Year : 2000 | Volume
| Issue : 1 | Page : 47-48
Polypoid cystitis with pachydermoperiostosis: An unusual association
Kanumury Ramesh, Rakesh Parasher, K Sasidharan
Department of Urology, Kasturba Medical College, Manipal, India
Department of Urology, Kasturba Medical College, Manipal - 576 119
Source of Support: None, Conflict of Interest: None
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
| Introduction|| |
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|| |
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. 
It has been frequently reported in patients with some inciting cause such as indwelling catheter, trauma, urinary obstruction,  malignancy, vesicointestinal fistula or radiation.  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,  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.  This case is also reported, as it is first of its kind in literature, to be associated with pachydermoperiostosis.
| References|| |
|1.||Resnick D. Enostosis, Hyperostosis and Periostosis. In: Resnick D (ed.). Diagnosis of bone and joint disorders (3''ed.). Philadelphia: Saunders. 1995: 4421-4427. |
|2.||Buck EG. Polypoid cystitis mimicking transitional cell carcinoma. J Urol 1984: 131: 963. |
|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. |
[Figure 1], [Figure 2]