Urinary Bladder Fibroepithelial Polyp Presenting with Gross Hematuria in a 10-Year-Old Girl

Abstract

Fibroepithelial polyps are rare benign lesions of mesodermal origin that may arise within the urinary tract. Urinary bladder involvement is uncommon, particularly in children. Because these lesions may appear as vascularized polypoid bladder masses, they may mimic other bladder tumors. Histopathological examination is therefore essential for definitive diagnosis. A 10-year-old girl presented on 24/07/2026 with a 9–10-day history of gross hematuria and a sensation of incomplete bladder emptying. She was clinically well, with mild suprapubic tenderness. Laboratory evaluation demonstrated hematuria, and urine culture grew Escherichia coli (>10⁵ CFU/mL). Antibiotic treatment was initiated; however, hematuria persisted. Abdominal and pelvic ultrasonography subsequently demonstrated a well-defined, approximately 1 × 1 cm vascularized hyperechoic lesion arising from the right posterior wall of the urinary bladder. The patient underwent cystoscopic excision of the lesion. Histopathological examination demonstrated a fibroepithelial polyp composed of fibrovascular stroma lined by urothelium, with reactive urothelial changes, acute inflammatory cell infiltration, and focal stromal infarction with hemorrhage and degenerative changes. No significant cytologic atypia, carcinoma in situ, or invasive malignancy was identified. The final diagnosis was fibroepithelial polyp with focal infarction and inflamed/reactive urothelium, negative for malignancy. The patient had a favorable postoperative course through 04/08/2026. Fibroepithelial polyp should be considered in the differential diagnosis of a bladder mass in children presenting with gross hematuria. Although imaging can identify the lesion, histopathological examination is essential for definitive diagnosis and exclusion of malignancy. Cystoscopic excision provides tissue for definitive diagnosis and treatment of an appropriate localized lesion.