| Summary: | Introduction There have been few reported cases of villous adenoma of the bladder. It commonly occurs in the superior area of the bladder with hematuria as the most common symptom. Here, we have presented a case of villous adenoma of the bladder neck and reviewed the existing literature. Case presentation A 90‐year‐old man presented with voiding difficulty. Although urine analysis revealed microscopic hematuria and pyuria, the patient never complained about gross hematuria. Ultrasonography and cystoscopic examination revealed a bladder tumor located at the bladder neck. Transurethral resection was performed and villous adenoma was diagnosed by histopathologic examination. Conclusion Villous adenoma of the bladder is a rare disease, which is difficult to diagnose when the patient presents with uncommon clinical features. Although villous adenoma is known as a benign tumor, some reports suggest its association with malignancy. Therefore, careful management and follow‐up are necessary.
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