Method: We present this 55 years old lady with urinary problem. Cystocopic examination show a sessile mass and biopsy show circumscribed proliferation of tubules, cysts, and papillae lined by cells with low cuboidal to columnar epithelial cell. Nephrogenic adenoma can be a significant diagnostic pitfall as certain histological features, such as the presence of enlarged nuclei with prominent nucleoli Results: Immunohistochemistery study showed strong reactivity to CK7, P504S, CD10, and EMA but negative for CK20, PSA, and P63. Conclusion: We recommend that any lesion in cystoscopic examination should be followed and immunohistochmistery examination some times is mandatory to differentiate them from malignant tumors.