# Snake-shaped tumor protruding from an ureteral orifice: a case of a long ureteral fibroepithelial polyp successfully resected ureteroscopically

## TL;DR

A rare 9.5 cm ureteral fibroepithelial polyp was successfully removed using ureteroscopy, avoiding more invasive surgery.

## Contribution

Demonstrates successful ureteroscopic resection of an exceptionally long fibroepithelial polyp.

## Key findings

- A 9.5 cm fibroepithelial polyp was diagnosed and resected ureteroscopically.
- The procedure avoided postoperative ureteral strictures and more invasive surgery.
- Ureteroscopy is critical for both diagnosing and treating long fibroepithelial polyps.

## Abstract

A fibroepithelial polyp (FEP) is a rare benign ureteral tumor that causes gross hematuria and ureteral obstruction. Diagnosis of FEP is difficult using ultrasound or radiographic imaging, and ureteroscopic diagnosis through direct vision is important. Although ureteroscopic resection is less invasive, FEP sometimes grows significantly in both length and size and requires open or laparoscopic ureteral resection. Here, we report a case in which we diagnosed and resected a 9.5 cm long FEP, originating from the mid-ureter, ureteroscopically. A 32-year-old woman with gross hematuria was referred to our hospital. Cystoscopy revealed a snakelike tumor protruding from the left ureteral orifice into the bladder. Ureteroscopy revealed a smooth tumor surface, with the root sufficiently narrow for resection. Based on these features, the tumor was diagnosed as an FEP and was ureteroscopically resected without postoperative ureteral strictures. Ureteroscopy is essential for the diagnosis and treatment of a long FEP.