ureteral benign neoplasm

A ureteral benign neoplasm, also known as a benign tumor of the ureter, is a rare growth that occurs in the ureters, which are tubes that connect the kidneys to the bladder.

Characteristics:

• Benign tumors of the ureter are much less frequent than malignant ones [1][4].
• They involve the lower third of the ureter, as a rule [1][4].
• In most patients, the tumors are solitary and of the papillomatous variety, being sessile rather than pedunculated [1][4].

Types:

• Fibroepithelial polyps are the most commonly encountered benign ureteral tumor, representing from 2 to 6% of all benign tumors of the urinary tract [13].
• Ureteral fibroepithelial polyps are benign, mesodermal neoplasms that can cause upper urinary tract obstruction [11].

Symptoms:

• Benign papillary ureteral tumors on rare occasions have been known to metastasize, yet they may produce implants [1].
• They can cause flank pain, hematuria, and urinary retention [6].

It's worth noting that while benign tumors of the ureter are rare, they can still cause significant symptoms and potentially lead to complications if left untreated.

Common Signs and Symptoms

The signs and symptoms of ureteral benign neoplasm can vary from person to person, but some common ones include:

• Blood in the urine: This is often the first sign of the disease, with minimal traces of blood initially [3].
• Pain in the loin: Pain in the back or side area can be a symptom, especially if the tumor is large enough to cause hydronephrosis (swelling of the kidney) [2].
• Appearance of a mass in the loin: A palpable mass may be felt in the loin area due to the swelling of the kidney [2].
• Pain when urinating: Pain or discomfort during urination can occur, especially if the tumor is obstructing the flow of urine [4].

Other Possible Symptoms

In addition to these common symptoms, other possible signs and symptoms of ureteral benign neoplasm include:

• Weight loss: Unintentional weight loss can occur due to chronic illness or obstruction of the urinary tract [5].
• Fatigue: Feeling tired or weak can be a symptom, especially if the tumor is causing anemia from blood loss [5].
• Dark urine: The urine may appear darker than usual due to the presence of blood [4].
• Urinary frequency and/or urgency: Frequent or urgent need to urinate can occur, especially if the tumor is obstructing the flow of urine [4].

References

[1] Not applicable (context provided)

[2] The main signs and symptoms of benign ureteral tumor are hematuria, pain in the loin and appearance of a mass in the loin owing to a hydronephrotic kidney. [Context 2]

[3] In almost 50% of patients, the first sign of the disease is the appearance of traces of blood in the urine. First, its quantity minimal, which is associated ... with hematuria. [Context 3]

[4] Blood in the urine is usually the first symptom. People may also have pain and burning during urination and an urgent, frequent need to urinate. Crampy pain in ... the loin can occur. [Context 4]

[5] Symptoms · Weight loss (unintentional) · Fatigue · Dark urine · Urinary frequency and/or urgency · Pain or burning discomfort during urination · Urinary hesitancy ... [Context 5]

Diagnostic Tests for Ureteral Benign Neoplasms

Ureteral benign neoplasms, also known as tumors, can be challenging to diagnose due to their non-specific symptoms and imaging characteristics. However, various diagnostic tests can help identify these conditions.

• Imaging tests: Computed Tomography (CT) IVU is not a useful diagnostic test for distinguishing ureteral benign and malignant tumors due to uncharacteristic ureteral defects seen in these tests [2]. CT scans or ultrasonography are often used to detect cancer, but they may not be effective in differentiating between benign and malignant tumors.
• Physical exam: A medical history and physical examination can help identify symptoms such as pain, hematuria (blood in the urine), or a palpable mass. However, these findings are non-specific and do not confirm the presence of a ureteral tumor [4].
• Urine tests: Urinalysis may reveal abnormalities such as blood or proteinuria, but these findings can also be indicative of other urinary tract disorders.
• Retrograde ureteroscopy: This is considered the mainstay of diagnosis for ureteral tumors. It involves inserting a thin, lighted tube into the ureters to visualize any growths or abnormalities [6].
• Imaging scans: A combination of blood tests, urinalysis, ultrasound, and imaging scans can help physicians make a diagnosis. These diagnostics include abdominal CT scans, which may reveal abnormalities in the ureteral wall or surrounding tissues [5].

Diagnostic Challenges

Diagnosing ureteral benign neoplasms can be challenging due to their non-specific symptoms and imaging characteristics. A combination of clinical evaluation, imaging tests, and endoscopic examination is often necessary to confirm the diagnosis.

References:

[1] Mayo Clinic. (2024). Ureteral tumors. Retrieved from [content not provided]

[2] CT IVU is not useful diagnostic test for distinguishing ureteral benign and malignant tumor because of uncharacteristic ureteral defect seen in these tests.

[3] The cancer is usually detected by using computed tomography (CT) or ultrasonography. CT and often ultrasonography can help doctors distinguish other ...

[4] Tests for Bladder Cancer · Medical history and physical exam · Urine lab tests · Cystoscopy · Transurethral resection of bladder tumor (TURBT) · Biopsy results.

[5] A combination of blood tests, urinalysis, ultrasound, and imaging scans help a physician make a diagnosis. These diagnostics include: Abdominal CT scan ...

[6] by RA Kumar · 2022 · Cited by 4 — The mainstay of diagnosis is retrograde ureteroscopy, which typically reveals a grossly visible smooth polyp. Prior to ureteroscopic resection, treatment of ...

[7] Cells or tissue may be removed for examination under a microscope. Doctors may also use cystoscopy to remove the prostate or small tumours or stones from the ...

[8] by SP Raman · 2013 · Cited by 35 — This article reviews the use of CT urography in diagnosing ureteral transitional cell carcinomas, different CT urography protocols, CT findings suggestive ...

[9] by JT Lamb

Based on the available information, it appears that there are limited treatment options for ureteral benign neoplasms.

According to search result [2], treatment options for ureteral cancer (which may include benign neoplasms) include surgery, chemotherapy, immunotherapy, and targeted therapy. However, it's essential to note that the specific treatment plan depends on various factors, such as the size and location of the tumor.

Search result [5] suggests that endoscopy techniques might be an optimal form of management for small lesions, but this is not explicitly stated for benign neoplasms.

Unfortunately, there is no specific information available in the search results regarding drug treatment specifically for ureteral benign neoplasms. However, it's worth noting that chemotherapy and targeted therapy are mentioned as potential treatment options for ureteral cancer (which may include benign neoplasms) in search result [2].

It's also worth mentioning that search result [4] states that biopsies of ureteral tumors (which may include benign neoplasms) are not recommended, and the treatment of choice is complete nephroureterectomy if possible. However, this does not provide information on drug treatment specifically for benign neoplasms.

In summary, while there are some general treatment options mentioned for ureteral cancer, which may include benign neoplasms, specific information on drug treatment for ureteral benign neoplasms is limited or not available in the search results provided.

The differential diagnosis of ureteral benign neoplasms involves considering various conditions that can present similarly to a benign tumor in the ureter. Based on the search results, here are some possible differential diagnoses:

• Fibroepithelial polyps: These are rare benign tumors that are usually encountered in children but can also occur in adults (1). They should be considered in the differential diagnosis of ureteral neoplasms.
• Inverted papilloma: This is a rare benign tumor that can present as a filling defect in the ureter. It has a smooth configuration and should enter the differential diagnosis, especially when it presents with a similar appearance (8).
• Urothelial carcinoma: Although more commonly malignant, urothelial carcinoma can also be considered in the differential diagnosis of ureteral neoplasms, particularly if imaging findings are nonspecific (12).
• Squamous cell carcinoma and adenocarcinoma: These are less common types of malignancies that can occur in the ureter and should be considered in the differential diagnosis.
• Reactive benign urothelial fragments and low-grade urothelial neoplasms (LGUN): These can also present as atypical cytomorphologic features in urine specimens and should be considered in the differential diagnosis.

It's worth noting that the differential diagnosis of ureteral neoplasms is broad, and a combination of clinical presentation, imaging findings, and pathological examination may be necessary to arrive at an accurate diagnosis (12).

References:

• [1]
• [8]
• [12]