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Nephrogenic adenoma was an incidental finding in this bladder biopsy from a 77 y/o female with a history of urothelial carcinoma of the renal pelvis. The lesion shows tubulo-papillary structures lined by cuboidal epithelium with chronic inflammatory cells in the stroma. Nine months later, she was found to have a suspicious "red velvety" area on follow-up cystoscopy. Biopsy showed recurrent nephrogenic adenoma.