Imaging of diffuse fibroepithelial polyps on surgical free flap in oral cancer patients: two case reports.

Fibroepithelial polyp (FEP) is a common benign tumor occurring in the skin and genitourinary tract, and there are no reports of multiple FEPs occurring on the myocutaneous flap. We report two cases of FEPs occurring diffusely on the skin tissue of the free anterolateral thigh flap after surgical reconstruction for oral squamous cell carcinoma. Clinically, multiple papillary nodules on the myocutaneous flap gradually increased. CT and MRI showed multiple papillary nodules on an enhanced layer covering the entire myocutaneous flap. PET/CT showed high uptake. One case was diagnosed with FEPs by surgery, the other by biopsy. The tumor-limited localization on the myocutaneous flap, characteristic morphology showing multiple papillary projection with an enhanced layer, and MRI signal showing patchy mild elevation of the apparent diffusion coefficient value may help in differential diagnosis from tumor recurrence or secondary carcinoma of the myocutaneous flap on diagnostic imaging.

Oral fibroepithelial polyps ("chewing granulomas") in 21 dogs: Histomorphology, immunohistochemical characterization, and clinical outcome.

Oral fibroepithelial polyps (FEPs) are common, benign, nonneoplastic lesions in humans that often develop slowly in sites of local irritation or trauma. This study analyzed 23 oral fibroepithelial polypoid lesions retrieved from 21 dogs (2014-2021). All lesions were pedunculated with usually an irregular/cauliflower-like or rarely smooth surface. FEPs most commonly arose under or lateral to the tongue; other sites included the labial and gingival mucosa, soft palate, and hard palate. All the lesions were characterized by a thick fibrovascular stalk consisting of bundles of fibrocytes and fibroblasts embedded in a collagenous matrix rich in blood vessels. The surface squamous epithelium, when evaluable, was hyperplastic (22/22; 100%) with frequent parakeratotic hyperkeratosis (12/22; 54.5%). Ulceration of variable extent was observed in 13/23 cases (56.5%). Inflammation was associated with 18/23 cases (78.3%), and was mostly lymphoplasmacytic. The connective tissue was consistently immunoreactive for vimentin and generally negative for smooth muscle actin and desmin. All FEPs in cases with available clinical outcome data did not recur after surgical excision. The presence of chronic inflammation and ulceration suggests a causative role of chronic irritation in the pathogenesis of canine oral FEPs. FEPs should be included among the differential diagnoses of proliferative lesions of the oral cavity in dogs.

Giant Anal Fibroepithelial Polyp in a Healthy Teenage Boy: A Case Report and Literature Review.

Background: Fibroepithelial polyps of the anus have been described as mucosal hypertrophy in response to chronic irritation or tissue damage. Lesions usually remain small and mostly present in elderly adults with local disease. Case Report: An otherwise healthy 15-year-old male presented with a giant pedunculated mass projecting out of the anal verge that enlarged over 2 years, causing discomfort. Results: Upon surgical excision and histologic examination, the mass resembled a fibroepithelial polyp with numerous dilated lymphatics. Conclusions: While literature describes the spectrum of pathology possible in such lesions, often consisting of a mixture of stromal and epithelial components, dilated lymphatics are less common. This giant anal fibroepithelial polyp characterized by edematous stroma and numerous dilated lymphatics is consistent with lymphangioma. To our knowledge, this presentation is novel in this age group with no underlying risk factors.

Skin tags imaged by reflectance confocal microscopy, optical coherence tomography and multispectral optoacoustic tomography at the bedside.

BACKGROUND: Skin tags are common and mostly benign, but occasionally contain skin cancers. This study analysed skin tags by combining three advanced optical imaging technologies: reflectance confocal microscopy (RCM), optical coherence tomography (OCT) and multispectral optoacoustic imaging (MSOT) supplemented by dermoscopy MATERIALS AND METHODS: A prospective clinical study recruiting patients with skin tags from a university hospital clinic over a 2-week period. OCT, RCM and MSOT imaging were performed prior to excisional biopsies. Image features such as pigmentation, cell types and skin architecture, angiographic information demonstrating vascular pattern were captured, analysed, and compared to melanin and haemoglobin content in MSOT as well as histopathology. RESULTS: Six patients with dermal naevi (2); compound naevi (3); neurofibroma (1) were included. All skin tags except the neurofibroma were pigmented (5/6), with sparse (5/6) and dense (4/6) hyperreflective nests and band-like collagen in dermis in 6/6 lesions on RCM. Dermoscopy showed dots (5/6) and coiled vessels (5/6). Linear vertical vessels were present in all OCT images. MSOT images consisted of a compact shell-like superficial melanin area, same shape and size as the skin tag, dermal vessels were visible in 4/5 naevi, HbO2 signal clearly demarcated blood vessels located below the melanin signal. CONCLUSION: OCT showed linear vessels in all lesions. Pigmentation was identified by RCM as benign nests of melanocytes. MSOT supplemented with spatial distribution of melanin and HbO2 that indicated all skin tags were benign with no infiltration of vessels inside the melanin signal. Each advanced method proved indispensable for fast diagnosis. Larger studies are warranted for validation.

Modified Laparoscopic Partial Ureterectomy for Adult Ureteral Fibroepithelial Polyp: Technique and Initial Experience.

OBJECTIVES: To present our modified laparoscopic partial ureterectomy technique for adult ureteral fibroepithelial polyp (FEP) and initial experience. METHODS: Between August 2009 and October 2017, 22 patients with ureteral FEP underwent modified laparoscopic partial ureterectomy by an experienced surgeon. In our method, a stay suture passing through the upper ureter was fixed to the abdominal wall to keep the ureter from twisting. The ureter was not completely dismembered until the first stitch, which was placed between the lowest points of the upper ureter and lower ureter end faces, was finished. Besides, we used a 3-step method to locate the polyp. Surgical success was defined as improved hydronephrosis and alleviated symptoms. RESULTS: The mean operative time was 152.18 min. The mean estimated blood loss was 22.73 mL. One patient complained of urinary tract infection postoperatively. The mean times to remove the drainage tube and catheter were 2.64 and 3.73 days respectively. The double-J tube was removed at 1-3 months after surgery. At a mean follow-up of 47.04 months, no patient experienced disease recurrence, and the operative success rate was 100%. CONCLUSIONS: Modified laparoscopic partial ureterectomy, with a high success rate, could be considered a safe and efficient treatment option for ureteral FEP.

Role of computed tomography urography in the clinical evaluation of upper tract urothelial carcinoma.

Intravenous urography has been widely used for the evaluation of upper tract urothelial carcinoma. However, computed tomography urography presently has a higher diagnostic accuracy for upper tract urothelial carcinoma (94.2-99.6%) than intravenous urography (80.8-84.9%), and has replaced intravenous urography as the first-line imaging test for investigating patients with a high risk of upper tract urothelial carcinoma. Although the detection rate for bladder tumors using standard computed tomography urography is not yet high enough to replace cystoscopy, the addition of a 60- to 80-s delayed scan after the administration of contrast material for the whole pelvis improves the detection rate. A drawback to computed tomography urography is the higher radiation dose of 15-35 mSv, compared with a mean effective dose of 5-10 mSv for intravenous urography. Among several approaches to reducing the radiation dose, the use of an iterative reconstruction algorithm is most likely to become an effective solution because of its simplicity. One advantage of computed tomography urography over intravenous urography is its ability to reliably differentiate between upper tract urothelial carcinoma and calculi or blood clots. Computed tomography urography also shows characteristic findings of other benign conditions. These findings, in combination with negative cytology, are very important diagnostic clues for avoiding an unnecessary nephroureterectomy. For the clinical staging, a recent study has reported the high diagnostic accuracy of computed tomography urography with respect to ≥pT3 tumors. The present review shows the current status of computed tomography urography for the evaluation of upper tract urothelial carcinoma.

[Fibroepithelial polyps of renal pelvis and ureter].

AIM: To analyze the results of surgical treatment of patients with long ureteral fibroepithelial polyps (FEP). MATERIALS AND METHODS: From 2005 to 2014 three patients (1 man and 2 women) with large FEP were observed in our hospital. In 2 patients the base of the polyp was located in the proximal ureter and in 1 patient in the middle calyx of the single kidney. The fibroepithelial polyps were long and extended down to the lower third of the ureter (2) or protruded into the bladder (1). Endoscopic resection of the polyp was made in 1patient, resection of parenchyma in the middle calyx along with the base of FEP in 1 patient with the single kidney, and another patient underwent laparoscopic nephrectomy due to the absence of kidney function. RESULTS: Endoscopic resection was successful; the operation lasted 45 minutes without complications. In the patients with a single right kidney operative time was 3.5 hours; during the operation, she received a blood transfusion. In the postoperative period, she underwent two hemodialysis sessions due to acute renal failure. Subsequently, her kidney function was restored. No FEP recurrences occurred in cases of organ sparing operations during follow-up. The postoperative period of the third patient submitted to laparoscopic nephrectomy was uneventful, creatinine levels remained in the normal range. CONCLUSION: For long, large ureteral FEPs with a broad base the choice of surgical option depends on possibility of tumor visualization and functional state of the kidney.

A rare cause of glans penis masses in childhood: Fibroepithelial polyp.

Fibroepithelial polyps of glans penis are very rarely seen in childhood. A 6-month-old male admitted to our institution with a slowly enlarging glans penis mass on the ventral side of the glans penis. The mass was totally excised, and hystopathological diagnosis was a fibroepithelial polyp. All of the reported cases published previously, except one, are of adult age and all of them have been associated with the history of long-term condom catheter use. The presence of the case in childhood; however, suggests that the pathology might be congenital. This is the second pediatric case presented in the English literature.

The nested variant of urothelial carcinoma arising in a fibroepithelial polyp: Report of a case and review of literature.

The nested variant of urothelial carcinoma is a rare but very important histological entity due to its deceptively bland-looking appearance and aggressive behavior. We present a case of a 30-year-old man who was found to have a solitary polypoid growth in the bladder. It was resected and found to be a fibroepithelial polyp; a rare entity in itself, harboring the above tumor. The lesion also showed a second population of scattered bizarre stromal cells. To our knowledge, this is the first instance of a nested variant of urothelial carcinoma arising in a fibroepithelial polyp. The presence of atypical stromal cells has also not been described previously.

Fibroepithelial polyps causing obstructive hydronephrosis treated with pyeloplasty: A case report.

Fibroepithelial polyps (FEP) are rare benign tumors urinary collecting system. Diagnosis is suspected on Computed Tomography (CT) and confirmed via histopathology. Treatment options vary from historic nephroureterectomy to more contemporary methods of ablation. Authors present a case of a symptomatic FEP causing left-sided hydronephrosis and episodic flank pain treated by a urologic surgeon. The patient underwent robotic pyeloplasty and excision of the tumors, yielding preserved renal function and resolution of the hydronephrosis.

Fibroepithelial Polyp of the Vagina in Pregnancy: A Case Report.

Fibroepithelial polyps of the Vagina (FEPV) are mucosal polypoid lesions with a connective tissue core covered by a benign squamous epithelium. They are thought to be rare as only a few cases are reported in the literature. Fibroepithelial stromal polyps are mesenchymal neoplasms that can occur in the vagina, vulva, and even on the cervix. These fibroepithelial stromal polyps have also been reported in rare sites such as breast and labia.

Recurrent fibroepithelial vaginal polyp in a 2-year-old girl: a case report and review of the literature.

Introduction and importance: Fibroepithelial vaginal polyps (FEPV) are rare mucosal polypoid lesions primarily found in adult women. However, FEPV in paediatric patients, especially beyond the neonatal period, is exceedingly uncommon. Documenting cases improves diagnosis and management. FEPV can mimic malignancy, posing challenges for interpretation. Early detection, treatment, and follow-up are crucial for optimal outcomes. Case presentation: The authors present the case of a 2-year-old girl with a recurrent FEPV. The patient had a painless, reddish, smooth, soft, rubbery polypoid vaginal mass measuring 2.3 × 1.5 cm. Physical examination revealed no concurrent systemic issues. Surgical excision of the polyps confirmed them as fibroepithelial polyps. Despite previous excisions, the polyps recurred within a month. The patient's postoperative recovery was uneventful, and subsequent follow-up showed no recurrence. Clinical discussion: FEPV presents as mucosal polypoid lesions with a connective tissue core covered by benign squamous epithelium. It is rare before menarche and after menopause. Although the pathophysiology remains unclear, hormonal factors and local injuries may contribute. FEPV is usually asymptomatic but may cause pressure, obstruction, bleeding, or discharge. Differential diagnosis includes vaginal connective tissue malignancies. The diagnosis was confirmed by surgical excision and histopathology. Complete excision is crucial for preventing recurrence. Conclusion: This case report highlights recurrent FEPV in a 2-year-old girl. Despite previous excisions, polyps recurred, emphasizing the need for complete excision. Documenting cases will enhance our understanding. Further research is needed to elucidate the pathogenesis of paediatric FEPV. Early detection, treatment, and follow-up are essential for optimal management.

Misdiagnosed Asthma Turned Out to Be Bronchial Fibroepithelial Polyp: Case Report and Review of Literature.

Bronchial fibroepithelial polyps are exceedingly rare with few cases have been reported. They can manifest with a wide array of symptoms; ranging from being totally asymptomatic, cough, refractory dyspnea, and hemoptysis. In our case, our patient's condition was diagnosed and was managed as asthma. It is one of the rare benign conditions to be encountered, shares similar morphology with other tumors such as angiomyofibroblastoma, aggressive angiomyxoma, and cellular angiofibroma. These lesions have a slow growth pattern which may end up with obstruction. According to the tumor size and symptoms caused by it, treatment varies from observation to complete resection. This case describes an incidental finding of fibroepithelial polyp in the main bronchus for a patient with long-term refractory cough for 5 years, was misdiagnosed to have asthma. Diagnosis typically involves imaging and bronchoscopy, followed by appropriate therapeutic measures and careful monitoring to assess the prognosis.

Androgen Receptor-Positive Penile Acrochordon: A Case Report.

Acrochordons are polypoid, skin-colored lesions usually present at the site of skin folds. They are extremely rare in the preputial area of the penis and do not tend to grow. To the best of our knowledge, in English literature, this report presents the first case of an androgen receptor-positive penile acrochordon, which is located on the penis and showed rapid growth along with body development during puberty with no underlying causes such as acromegaly, diabetes, obesity, and trauma.

Fibroepithelial Polyp of the Vagina With Torsion: A Difficult Diagnosis Based on Clinical and Morphological Findings of the Vaginal Lesion.

Vaginal fibroepithelial polyps are rare benign tumors of the mucosa of the anterior vaginal wall. In extremely rare cases, they may originate from the posterior vaginal wall or be complicated by torsion. Our case concerns a 63-year-old patient who presented to the gynecology outpatient clinic of the General Hospital of Trikala with minor vaginal bleeding. On vaginal examination, a large pedunculated painless hemorrhagic polypoid mass was noticed, originating from the posterior vaginal wall. A torsion of the pedunculated vaginal tumor was suspected, leading to its surgical excision with clear resection margins. Due to extensive tissue necrosis, accurate histological identification of the vaginal neoplasm was not possible. Histological examination excluded vaginal malignancy. Based predominantly on the clinical and morphological features of the vaginal lesion, a diagnosis of vaginal fibroepithelial polyp with torsion was made, acknowledging its limitations. The patient was discharged from the clinic the same afternoon following the surgery. Three months later, no recurrence of the lesion in the vaginal wall was noted. Following the case presentation, this paper provides a brief literature review of this rare entity, focusing on the diagnostic and therapeutic approaches.

Unveiling the Truth: Fibroepithelial Polyp of the Vulva and Its Misdiagnosis as Cancer.

Fibroepithelial polyps (FEPs) are peculiar benign lesions that typically present as painless, pedunculated growths in various regions of the body, including the lower female genital tract. We discuss a case of a 45-year-old menopausal female who presented with an FEP in her vulva. The patient reported noticing a painless growth in her vulvar region for the past seven years, which had gradually increased in size. Clinical examination revealed a polypoidal, pedunculated, fleshy mass measuring approximately 11x8x7 cm in diameter. The lesion was excised under anesthesia, and histopathological examination confirmed the diagnosis of FEP. The patient had an uneventful postoperative course and showed no evidence of recurrence.

Giant inflamed fibroepithelial scrotal polyp mimicking an anogenital wart.

We report the case of a young man who has never had any sexual contact presenting with a large scrotal lump with secondary bacterial infection. He reported no prior warts - genital or cutaneous. On examination, he had a large pink cauliform mass on the scrotum with four smaller but similar satellite lesions. Appearances were thought to be consistent with giant condyloma of Buschke and Lowenstein. Once superinfection was treated with oral antibiotics, he had a trial of imiquimod without success and was then referred to urology. After surgical excision, pathology concluded it was an inflamed fibroepithelial polyp with no malignant changes. To our knowledge, this is the first case report of a giant scrotal fibroepithelial polyp with characteristic gross warty features in an adult.

Neonatal urethral polyps associated with Beckwith-Wiedemann syndrome.

We report the first case of Beckwith-Wiedemann syndrome without urinary obstruction, but with a congenital urethral polyp as a tumor protruding from the external urinary meatus. The present case suggests a possible relation between Beckwith-Wiedemann and the onset of fibroepithelial polyps in the reno-urinary system during the neonatal period.

A rare case of urethral fibroepithelial polyp in a young boy.

Urethral fibroepithelial polyps are uncommon benign tumors. The clinical presentation comprises of acute urinary retention, obstructive bladder symptoms such as frequent urination and urination difficulties, and hematuria. Usually, the diagnosis is made through the use of ultrasonography, voiding cystourethrography, and urethrocystoscopy. This study presents a case report of a four-year-old patient with urinary retention and frequent urination symptoms who was diagnosed with a urethral fibroepithelial polyp in the light of the literature.

Giant Tracheal Fibroepithelial Polyp Treated Successfully by High-Frequency Electrocautery Ablation.

Endotracheal fibroepithelial polyp is a rare disease in the airways. This report describes a rare case of a tracheal giant fibroepithelial polyp. A 17-year-old woman was admitted to the hospital with severe acute respiratory failure. Chest computed tomography revealed a tumor located below the epiglottis. Endotracheal bronchoscopic examination showed a giant polyp. This endotracheal polyp was removed with ablation, by using high-frequency electricity through flexible bronchoscopy under intravenous anesthesia. The patient has had a good recovery after the intervention and at long-term follow-up. We herein describe and discuss the appropriate therapeutic approach and also review the pertinent literature.