Fibroepithelial Polyp of the Proximal Ureter Presenting as Chronic Hematuria and Hydronephrosis in an Adolescent: A Case Report

Fibroepithelial polyps of the ureter are rare benign lesions that can produce long-standing obstruction and hematuria and may be misinterpreted as calculi or malignancy, risking delayed diagnosis and renal injury. We report the case of a 17-year-old male with a 10-year history of intermittent left flank pain and recurrent macroscopic hematuria, whose recent symptom progression prompted imaging that revealed grade-3 left hydronephrosis and a focal intraluminal soft-tissue density at the ureteral transition zone. Diagnostic ureteroscopy demonstrated a fungating polypoid mass in the upper third of the left ureter; endoscopic biopsy and subsequent histopathology confirmed a fibroepithelial ureteral polyp. The lesion was managed by segmental ureteral excision with primary end-to-end anastomosis; postoperative recovery was uneventful and follow-up intravenous pyelography showed normal renal drainage. This case highlights the diagnostic challenge posed by ureteral fibroepithelial polyps and reinforces the role of ureteroscopic assessment with targeted biopsy to enable kidney-sparing treatment and prevent unnecessary radical surgery.