title: Is surveillance necessary for inverted papilloma in the urinary bladder and urethra?
abstract: BACKGROUND
  A case series of inverted papilloma of the urinary bladder and urethra is presented, together with a review of the literature with respect to multiplicity, recurrence rate and association with transitional cell carcinoma, and a discussion on surveillance of the lesion.
  
  
  METHODS
  Cases of inverted papilloma of the lower urinary tract in a single centre were reviewed. Patient and tumour characteristics, recurrence and associated transitional cell carcinoma are reported.
  
  
  RESULTS
  Twenty patients were included (18 male, two female). The mean age was 60.8 years (range 35-78 years). All had solitary tumours ranging from 3 mm to 30 mm in size. Median cystoscopic follow up was 30 months (range 2-140 months). There was no recurrence. One patient was associated with subsequent transitional cell carcinoma 44 and 76 months later. Together with the present 20 cases, review of the English literature with respect to inverted papilloma of the lower urinary tract identified a total of 322 cases reported, with a recurrence rate of 3.85%. Moreover, 1.55%, 5.90% and 1.54% were associated with previous, simultaneous and subsequent transitional cell carcinoma, respectively.
  
  
  CONCLUSIONS
  Recurrence is not uncommon and risk of subsequent transitional cell carcinoma is not rare, such that non-invasive surveillance with flexible cystoscopy is recommended for inverted papilloma of the lower urinary tract.
authors.affiliation: Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong. drmcheng@hotmail.com
authors.forename: Chi Wai
authors.initials: CW
authors.lastname: Cheng
authors.forename: Lung Wai
authors.initials: LW
authors.lastname: Chan
authors.forename: Chi Kwok
authors.initials: CK
authors.lastname: Chan
authors.forename: Chi Fai
authors.initials: CF
authors.lastname: Ng
authors.forename: Ho Yuen
authors.initials: HY
authors.lastname: Cheung
authors.forename: Shu Yin Eddie
authors.initials: SY
authors.lastname: Chan
authors.forename: Wai Sang
authors.initials: WS
authors.lastname: Wong
authors.forename: Ka Fai
authors.initials: KF
authors.lastname: To
mesh_terms: D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D018308:Papilloma, Inverted / Q000473:pathology / Q000601:surgery*; D011159:Population Surveillance; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014523:Urethral Neoplasms / Q000473:pathology / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*