Bladder, ureter & renal pelvis
Glandular neoplasms
Villous adenoma

Topic Completed: 1 December 2014

Minor changes: 8 December 2019

Copyright: 2003-2019,, Inc.

PubMed Search: Villous adenoma [title] bladder

Monika Roychowdhury, M.D.
Page views in 2019: 1,459
Page views in 2020 to date: 845
Cite this page: Roychowdhury M. Villous adenoma. website. Accessed July 10th, 2020.
Definition / general
  • Rare bladder tumor similar to colonic counterpart
  • Also called villous tumor
  • Rare
  • Typically elderly patients, more commonly found in men (Int J Urol 2008;15:551)
  • Wide age range, but usually 40-70 years
  • Arise throughout urinary tract, but most common in bladder
  • In bladder, dome and the posterior wall are the most common sites; also urachus and trigone
Clinical features
  • Hematuria, mucusuria and irritative symptoms
  • May be associated with in situ or invasive adenocarcinoma at diagnosis, less often with in situ or invasive urothelial carcinoma
Prognostic factors
  • Excellent prognosis if isolated, poorer if only in-situ adenocarcinoma and well sampled, poorest if in situ or invasive urothelial carcinoma (Hum Pathol 2002;33:236)
Case reports
Gross description
  • Resembles papillary urothelial carcinoma
  • Resembles colonic villous adenoma with pointed processes lined by pseudostratified columnar epithelium with nuclear stratification, nuclear crowding, nuclear hyperchromasia, occasional prominent nucleoli, occasional mitoses
  • Associated with cystitis glandularis and cystitis cystica
  • MUST sample entire lesion to rule out adenocarcinoma (in situ or invasive)
Microscopic (histologic) images

Contributed by Carlos C. Diez Freire, M.D., University of Florida

60 year old man with Zinner syndrome, including a solitary right pelvic kidney and chronic kidney disease, who presented with obstructive symptoms

AFIP images

Fig 2-52: Polypoid and villous adenoma arising at bladder dome

Images hosted on other servers:

Arising in urachal cyst

Finger-like projections

Resembles colonic adenoma

Papillary fronds covered by columnar epithelium

With coexisting adenocarcinoma

Positive stains
Negative stains
Differential diagnosis
Back to top