Transitional Cell Carcinoma of the Bladder in the Pediatric Patient

Hoenig, David M.; McRae, Simon; Chen, Shu Chyan; Diamond, David A.; Rabinowitz, Ronald; Caldamone, Anthony A.

doi:10.1016/s0022-5347(01)66000-2

Cited by 73 publications

(41 citation statements)

References 23 publications

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“…2 They also seem to have a lower rate of recurrence than similarly staged tumours in the adult population, possibly due to field change being a less likely etiology in the absence of carcinogen exposure. 3 As in our case, painless gross hematuria is the presenting symptom in >90% of cases. There are no specific risk factors in the small number of cases reported.…”

Section: Discussionsupporting

confidence: 62%

“…However, we would interpret this protocol with caution, given the very small series. 3 The Canadian Urological Association (CUA) guidelines for adults would suggest followup cystoscopy for all patients at three months, followed by cystoscopy with cytology at 12 months, and then annually for Ta low-grade tumours.…”

Section: Urothelial Carcinoma Of the Bladder In Childrenmentioning

confidence: 99%

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Urothelial carcinoma of the bladder in a pediatric patient

Mau

Leonard

2016

CUAJ

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Urothelial carcinoma of the bladder in children and adolescents is rare. The World Health Organization database has recorded approximately 80 patients under age 16 that have been diagnosed with papillary bladder tumour since 1968. 1 We are reporting on our case of urothelial carcinoma diagnosed in a 14-year-old male who presented with painless gross hematuria. Case reportOur patient is a 14-year-old South Asian male, who immigrated to Canada from the Philippines in 2012. He had an isolated episode of painless, gross hematuria in July 2015, after which he presented to his primary care physician and renal and bladder ultrasound was ordered. Referral was also made to urology at that time.The patient's medical history was significant for a remote history of pulmonary tuberculosis for which he received treatment, as well as a history of an intestinal parasite. The remainder of the history was non-contributory for typical risk factors of urothelial carcinoma, including no history of chemotherapy, radiation, or chemical exposure. He and his family denied history of tobacco usage and there was no family history of genitourinary malignancy.Physical examination revealed a normal abdominal and genitourinary examination.Ultrasound revealed an irregular lobulated polypoid lesion on the right postero-lateral bladder wall measuring 26 x 29x 17 mm (Fig. 1). The kidneys were unremarkable.The patient was taken to the operating room for a cystoscopy and transurethral resection of bladder tumour. Cystoscopy revealed a papillary lesion on the right posterolateral bladder wall just distal to the ureteric orifice, consistent with what was seen on imaging. Due to the patient's post-pubertal stage of genital development, the pediatric resectoscope could not reach the tumour. We gently dilated his urethra with sounds and used the 26 F resectoscope for resection. The tumour was completely resected and a sample was taken at the base.Pathology revealed a low-grade papillary urothelial neoplasm with no definite invasion into the muscularis mucosae. Also reported was a large inverted component, the presence of small nests of urothelial cells in the stalk, and the strong staining for CK5 and CD44. Final pathology read papillary low-grade urothelial carcinoma without invasion (Ta). DiscussionThough uncommon, there have been several consistent findings in regards to papillary bladder tumour occurrence in children. Tumours are predominately low-grade, more common in males at a 3:1 ratio, more common in White compared to Black patients, and are most often located on the trigone.2 They also seem to have a lower rate of recurrence than similarly staged tumours in the adult population, possibly due to field change being a less likely etiology in the absence of carcinogen exposure.3 As in our case, painless gross hematuria is the presenting symptom in >90% of cases. There are no specific risk factors in the small number of cases reported. Associations reported in children include passive smoking, exposure to cyclophosphamide or muscle relaxant...

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Section: Discussionsupporting

confidence: 62%

Section: Urothelial Carcinoma Of the Bladder In Childrenmentioning

confidence: 99%

Urothelial carcinoma of the bladder in a pediatric patient

Mau

Leonard

2016

CUAJ

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“…The most common symptom of bladder urothelial tumors in children is gross hematuria [3]. A urothelial tumor in the bladder is typically located in the trigone or ureteric orifices and the lateral bladder wall [1,4].…”

Section: Discussionmentioning

confidence: 99%

“…In a small contemporary series, ultrasonography was extremely effective in identifying bladder tumors, and the authors argued for its use in initial diagnosis and disease surveillance [3]. As the technology and image quality of ultrasonography has advanced, it has become more sensitive in identifying bladder urothelial tumors in pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

Urothelial Tumors of the Urinary Bladder in Two Adolescent Patients: Emphasis on Follow-up Methods

et al. 2014

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Here we describe two cases of papillary urothelial neoplasm of low malignant potential in adolescent boys. One case was a 16-year-old boy with a polypoid mass beside the right ureteral orifice and the other case was a 13-year-old boy with a papillary mass beside the left ureteral orifice. The initial presentation was hematuria in both cases and the bladder mass was detected by ultrasonography. Complete resection of the bladder tumor was performed by using an 11-Fr pediatric resectoscope. Follow-up has been performed with urine analysis, urine cytology, and bladder ultrasonography or cystoscopy every 3 months with no evidence of recurrence.

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“…Although potentially lacking the sensitivity of cystoscopy, ultrasound is acceptable and desirable in the pediatric population, as described by other authors. 15 Many series report recurrences, and the authors of these reports suggest long-term follow-up. 16 Therefore, we believe these patients merit follow-up, with the benign tumours (papilloma and PUNLMP) followed with at least one postoperative cystoscopy and annual surveillance with clinic visit, urine cytology and an ultrasound.…”

mentioning

confidence: 99%

Mimickers and tumours in the lower urinary tract: Need for a more efficient vigilance?

Metcalfe

Bascom

Sergi

2013

CUAJ

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Lower urinary tract symptoms are common in pediatric urology, but an atypical presentation may portend significant pathophysiology. We present 5 cases of young males with a sudden change in urinary symptoms, which resulted in the discovery of a variety of benign bladder tumours. We present the clinical, radiologic and histologic findings of these cases emphasizing on mimickers in clinics. Although rare tumours, these may be increasing in frequency and pediatric care may further be enhanced by the development of multinational registry.

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Transitional Cell Carcinoma of the Bladder in the Pediatric Patient

Cited by 73 publications

References 23 publications

Urothelial carcinoma of the bladder in a pediatric patient

Urothelial carcinoma of the bladder in a pediatric patient

Urothelial Tumors of the Urinary Bladder in Two Adolescent Patients: Emphasis on Follow-up Methods

Mimickers and tumours in the lower urinary tract: Need for a more efficient vigilance?

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