1
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Agarwal S, Sharma D, Pandey S, Sankhwar S. Benign fibroepithelial bladder polyp: a rare cause of childhood haematuria. BMJ Case Rep 2018; 2018:bcr-2018-226050. [PMID: 30150352 DOI: 10.1136/bcr-2018-226050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Haematuria in paediatric population is common yet alarming. It warrants a thorough physical examination and other investigations. Of late, a number of extremely rare aetiology of childhood haematuria have come to forefront. One such uncommon cause is benign fibroepithelial urinary bladder polyp. The presentation is of a child with intermittent haematuria exacerbated by physical/sports activity associated with or without suprapubic pain. Diagnosis is usually made by ultrasonography and cystoscopy and confirmed by histopathological examination. Treatment is surgical and involves cystoscopic transurethral resection of the mass. The exact aetiology of benign fibroepithelial polyp is uncertain with no clear guidelines on long-term surveillance. However, these cases should be subjected to cystourethroscopy if haematuria recurs. Treatment is surgical with good long-term prognosis. Not much is written in literature about benign fibroepithelial bladder polyp.
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Affiliation(s)
- Samarth Agarwal
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Deepanshu Sharma
- Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Siddharth Pandey
- Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Satyanarayan Sankhwar
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
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2
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Marinoni F, Destro F, Selvaggio GGO, Riccipetitoni G. Urothelial carcinoma in children: A case series. Bull Cancer 2018; 105:556-561. [PMID: 29724585 DOI: 10.1016/j.bulcan.2018.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 10/03/2017] [Accepted: 03/05/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To report a series of 5 patients with urothelial bladder cancer (UBC) three of them with a history of exposure to amines and only two with gross hematuria. MATERIALS AND METHODS After obtaining ethical and legal authorization, we performed a restrospective monocentric study. We collected information of patients with UBC over a period of 10 years. We recorded: age, sex, reason for presentation, familial history and risk factors, preoperative assessment, surgical details, histological type and grade, follow-up. RESULTS 2 children came to our attention for hematuria and 3 for incidental bladder mass finding, at a median age of 11.8 years. We performed microscopically complete transurethral resection of the tumor (TURB). Median tumor size was 1.8cm. No further therapy was required. All cancers belonged to NMIBC (Non-muscle-invasive Bladder Cancer) considering the 2004 WHO classification: 2 urothelial papillomas, 2 papillary tumors with low grade malignancy (PUN-LPM) and 1 papillary urothelial carcinoma of low histological grade (LG-PUC Ta, N0, M0). There was not any complications and no relapse occurred during follow-up (median 30 months). CONCLUSIONS In this study, UBCs presenting at a young age were low-grade and have not recurred in follow-up. This confirms the results of other series reported in Literature. Therefore there might be the space to perform a follow-up dedicated to children.
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Affiliation(s)
- Federica Marinoni
- Ospedale dei Bambini V. Buzzi, Pediatric Surgery Department, Via Castelvetro 32, 20154 Milano, Italy
| | - Francesca Destro
- Ospedale dei Bambini V. Buzzi, Pediatric Surgery Department, Via Castelvetro 32, 20154 Milano, Italy.
| | | | - Giovanna Riccipetitoni
- Ospedale dei Bambini V. Buzzi, Pediatric Surgery Department, Via Castelvetro 32, 20154 Milano, Italy
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3
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Grapin-Dagorno C, Peycelon M, Philippe-Chomette P, Berrebi D, El Ghoneimi A, Orbach D. [Urothelial tumors in children]. Bull Cancer 2016; 104:195-201. [PMID: 28034440 DOI: 10.1016/j.bulcan.2016.11.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 11/26/2016] [Indexed: 11/29/2022]
Abstract
Urothelial tumors are very rare in children (to date, only about 150 cases have been reported worlwide). Only 20% occur before the age of ten. The aim of this study is to specify the clinicopathologic features of urothelial tumor in young patients, which require a slightly different approach to treatment. On the basis of the WHO/ISUP (World Health Organisation/International Society of Urological Pathology) consensus classification report, these lesions are usually low-grade lesions, non invasive, and rarely recurrent. The sex ratio is three boys to one girl. These tumors are located preferentially in the low urinary tract, especially in the bladder. The main symptom is the macroscopic hematuria, which requires ultrasound examination in all cases. Cystoscopy is indicated in case of lesion of the bladder wall, or in case of persistent or recurrent hematuria, to obtain definitive diagnosis and biopsies. The tumors are mainly located on the posterior or lateral bladder wall above the trigone or near the ureteral orifices. Treatment is based on the transurethral resection of the lesion. The subsequent monitoring is sparsely codified, due to the exceptional occurrence of these tumors in the paediatric age group. These patients are likely to have better outcome than older patients, but it is due to the predominance of noninvasive papillary urothelial tumors. Tumor recurrences are not uncommon. In case of invasive, high-grade urothelial carcinomas, metastases or even lethal outcome may occur in rare cases.
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Affiliation(s)
- Christine Grapin-Dagorno
- Hôpital Robert-Debré, service de chirurgie viscérale et urologique, 48, boulevard Sérurier, 75019 Paris, France.
| | - Matthieu Peycelon
- Hôpital Robert-Debré, service de chirurgie viscérale et urologique, 48, boulevard Sérurier, 75019 Paris, France
| | - Pascale Philippe-Chomette
- Hôpital Robert-Debré, service de chirurgie viscérale et urologique, 48, boulevard Sérurier, 75019 Paris, France
| | - Dominique Berrebi
- Hôpital Robert-Debré, service d'anatomopathologie, 48, boulevard Sérurier, 75019 Paris, France
| | - Alaa El Ghoneimi
- Hôpital Robert-Debré, service de chirurgie viscérale et urologique, 48, boulevard Sérurier, 75019 Paris, France
| | - Daniel Orbach
- Institut Curie, service d'oncopédiatrie, 26, rue d'Ulm, 75005 Paris, France
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4
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Wang Z, Xiong W, Pan C, Zhu L, Wang X, Huang Z, Zhao X, Zhong Z. Aggressive muscle-invasive bladder cancer with sarcomatoid differentiation in a 10-year-old girl: A case report. Exp Ther Med 2016; 11:985-987. [PMID: 26998024 DOI: 10.3892/etm.2016.3012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 10/27/2015] [Indexed: 11/06/2022] Open
Abstract
The present study reports an unusual case of high-grade bladder cancer in a 10-year-old girl who complained of painless hematuria and urinary frequency. The tumor displayed sarcomatoid differentiation and an aggressive behavior, which required the administration of adjuvant chemotherapy. However, the disease progressed and the patient succumbed 6 months after surgery. It is known that the majority of malignant bladder cancers in pediatric patients are low-grade and present at an early stage, whereas sarcomatoid differentiation in the setting of a high-grade urothelial carcinoma is indicative of a poor prognosis. It is important that gross hematuria in pediatric patients is investigated carefully. It is recommended that the management of urothelial neoplasia in young patients should be predominantly decided on the basis of the grade and stage of the tumor rather than the age of the patient.
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Affiliation(s)
- Zijian Wang
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Wei Xiong
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Cizhong Pan
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Liang Zhu
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Xinjun Wang
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Zhichao Huang
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Xiaokun Zhao
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Zhaohui Zhong
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
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5
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Zangari A, Zaini J, Gulìa C. Genetics of Bladder Malignant Tumors in Childhood. Curr Genomics 2016; 17:14-32. [PMID: 27013922 PMCID: PMC4780472 DOI: 10.2174/1389202916666151014221954] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/25/2015] [Accepted: 06/30/2015] [Indexed: 12/30/2022] Open
Abstract
Bladder masses are represented by either benign or malignant entities. Malignant bladder tumors are frequent causes of disease and death in western countries. However, in children they are less common. Additionally, different features are found in childhood, in which non epithelial tumors are more common than epithelial ones. Rhabdomyosarcoma is the most common pediatric bladder tumor, but many other types of lesions may be found, such as malignant rhabdoid tumor (MRT), inflammatory myofibroblastic tumor and neuroblastoma. Other rarer tumors described in literature include urothelial carcinoma and other epithelial neoplasms. Rhabdomyosarcoma is associated to a variety of genetic syndromes and many genes are involved in tumor development. PAX3-FKHR and PAX7-FKHR (P-F) fusion state has important implications in the pathogenesis and biology of RMS, and different genes alterations are involved in the pathogenesis of P-F negative and embryonal RMS, which are the subsets of tumors most frequently affecting the bladder. These genes include p53, MEF2, MYOG, Ptch1, Gli1, Gli3, Myf5, MyoD1, NF1, NRAS, KRAS, HRAS, FGFR4, PIK3CA, CTNNB1, FBXW7, IGF1R, PDGFRA, ERBB2/4, MET, BCOR. Malignant rhabdoid tumor (MRT) usually shows SMARCB1/INI1 alterations. Anaplastic lymphoma kinase (ALK) gene translocations are the most frequently associated alterations in inflammatory myofibroblastic tumor (IMT). Few genes alterations in urothelial neoplasms have been reported in the paediatric population, which are mainly related to deletion of p16/lnk4, overexpression of CK20 and overexpression of p53. Here, we reviewed available literature to identify genes associated to bladder malignancies in children and discussed their possible relationships with these tumors.
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Affiliation(s)
| | - Johan Zaini
- Università degli Studi della Tuscia, dipartimento di scienze biologiche (DEB), Viterbo, Italy
| | - Caterina Gulìa
- Università degli Studi di Roma La Sapienza, Dipartimento di Urologia, Roma, Italy
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6
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Chu S, Singer J. Transitional Cell Carcinoma in the Pediatric Patient: A Review of the Literature. Urology 2016; 91:175-9. [PMID: 26802795 DOI: 10.1016/j.urology.2015.12.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 12/08/2015] [Accepted: 12/16/2015] [Indexed: 11/25/2022]
Abstract
Transitional cell carcinoma (TCC) is extremely rare in children, with fewer than 30 cases reported in patients under 10 years old. It is thought that pediatric TCC is fundamentally different than TCC in adults; however, there are no specific guidelines for management or surveillance. Furthermore, the addition of papillary urothelial neoplasm of low malignant potential as a diagnosis has changed the management of lesions previously considered malignant. This review aims to investigate the difference between TCC in adults and children, to report current strategies for management of pediatric TCC, and to analyze the effects of the new grading system.
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Affiliation(s)
- Stephanie Chu
- Department of Urology, University of California, Los Angeles, Los Angeles, CA.
| | - Jennifer Singer
- Department of Urology, University of California, Los Angeles, Los Angeles, CA
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7
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Umlauf VN, Coerdt W, Leuschner I, Schröder A, Stein R, Beetz R. How to Name Papillary Tumors of the Bladder in Children: Transitional Cell Carcinoma or Papillary Urothelial Neoplasm of Low Malignant Potential? Urology 2015; 86:379-83. [PMID: 26169007 DOI: 10.1016/j.urology.2015.04.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 04/12/2015] [Accepted: 04/15/2015] [Indexed: 10/23/2022]
Abstract
Urinary bladder malignancies are uncommon in children. Approximately 80 children with papillary carcinoma have been described to date, presenting as papillary neoplasms of both low grade and low stage. On the basis of the 1973 World Health Organization classification, tumors were classified as transitional cell carcinoma of the urinary bladder (TCCB). Owing to more detailed histologic criteria, this term has been replaced by papillary urothelial neoplasm of low malignant potential and low-grade carcinoma of the urinary bladder in the World Health Organization-International Society of Urologic Pathology consensus classification system of urothelial neoplasms 2004. Nevertheless, TCCB still remains a common term in contemporary literature. Thus, the differences between papillary urothelial neoplasm of low malignant potential, low-grade carcinoma of the urinary bladder, and TCCB will be illustrated by means of 4 examples of pediatric patients with papillary tumors.
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Affiliation(s)
- Volker N Umlauf
- Division of Neonatology and Pediatric Intensive Care, Department of Pediatrics, University Hospital RWTH Aachen, Aachen, Germany; Division of Pediatric Nephrology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Wiltrud Coerdt
- Institute of Human Genetics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ivo Leuschner
- Kiel Paediatric Tumor Registry, Department of Paediatric Pathology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Annette Schröder
- Department of Pediatric Urology, University Medical Center Regensburg, Hospital St. Hedwig, Regensburg, Germany; Division of Pediatric Urology, Department of Urology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Raimund Stein
- Division of Pediatric Urology, Department of Urology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Rolf Beetz
- Division of Pediatric Nephrology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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8
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Di Carlo D, Ferrari A, Perruccio K, D'Angelo P, Fagnani AM, Cecchetto G, Bisogno G. Management and follow-up of urothelial neoplasms of the bladder in children: a report from the TREP project. Pediatr Blood Cancer 2015; 62:1000-3. [PMID: 25545665 DOI: 10.1002/pbc.25380] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 11/05/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND Urothelial neoplasms of the bladder (UNB) are rare in patients under 20 years of age, and even rarer in the first decade of life. The present series was investigated to provide recommendations on patient management in terms of therapeutic strategy and follow-up. PROCEDURE This is a retrospective analysis on 12 patients with UNB under 18 years of age. Data were extracted from the national database of the TREP (Tumori Rari in Età Pediatrica) Project. RESULTS Ten of the 12 patients presented with a single episode of hematuria, while the discovery of the lesion was incidental in two. Eleven of the 12 lesions were G1 and one was G2/G3; none of the lesions invaded the lamina propria. All lesions were removed completely by transurethral resection. No further treatment was administered in nine children but three received a single dose of intravesical chemotherapy (epirubicin in 2, mitomycin in 1). Only one patient experienced a recurrence and all patients are alive in complete remission with a median follow-up of 30 months (range 4-112). Follow-up investigations varied at the different centers and included abdominal ultrasound in nine patients, cystoscopy in seven, and additional radiological investigations in a few cases. CONCLUSIONS UNB in children seems to be a low-grade, scarcely aggressive disease with an excellent prognosis. The role of intravesical chemotherapy is debatable. Follow-up can be based on ultrasound. The adoption of shared recommendations should enable unnecessary treatment and invasive investigations to be avoided.
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Affiliation(s)
- Daniela Di Carlo
- Department of Women's and Children's Health, Hematology/Oncology Division, Padova University Hospital, Padova, Italy
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9
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Huang H, Sun M, Li X, Jin J. Urothelial carcinoma of the bladder in patients aged 30 years or younger: clinicopathological analysis and expression of fibroblast growth factor receptor 3 (FGFR3) of 45 cases. Med Oncol 2015; 32:137. [DOI: 10.1007/s12032-015-0581-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 03/14/2015] [Indexed: 10/23/2022]
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10
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Ander H, Dönmez Mİ, Yitgin Y, Tefik T, Ziylan O, Oktar T, Özsoy M. Urothelial carcinoma of the urinary bladder in pediatric patients: a long-term follow-up. Int Urol Nephrol 2015; 47:771-4. [PMID: 25787072 DOI: 10.1007/s11255-015-0950-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 03/07/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To report our experience and long-term follow-up data on pediatric patients with urothelial carcinoma (UC) of the urinary bladder. METHODS In this retrospective study, perioperative and long-term follow-up data of nine pediatric patients with neoplasms of urothelial origin within the urinary bladder between 1980 and 2014 were analyzed. Cystoscopy was performed under general anesthesia, and transurethral resection of the bladder tumors was carried out in the same session. Adult follow-up protocols were used for all patients. RESULTS Urothelial carcinoma of the urinary bladder was histologically verified in five male (66%) and three female (33%) patients. In one patient, papillary urothelial neoplasm of low malignant potential was detected. Median patient age at the time of diagnosis was 12 years (4-18 years). Mean tumor size was 2.2 cm (1.5-4 cm). After a median follow-up of 60 months (10-121 months), no recurrence was observed among our patients. CONCLUSION Urothelial carcinoma of the urinary bladder in pediatric patients is a rare condition. Due to lack of substantial data, it is difficult to establish tailored management strategies. Most patients present with low-grade, low-stage disease. Being the most common symptom, macroscopic hematuria should be clarified with cystoscopy in pediatric age group.
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Affiliation(s)
- Haluk Ander
- Department of Urology, Istanbul Medical Faculty, Istanbul University, Capa, 34093, Istanbul, Turkey
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11
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Berrettini A, Castagnetti M, Salerno A, Nappo SG, Manzoni G, Rigamonti W, Caione P. Bladder urothelial neoplasms in pediatric age: experience at three tertiary centers. J Pediatr Urol 2015; 11:26.e1-5. [PMID: 25305695 DOI: 10.1016/j.jpurol.2014.08.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 08/11/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Urothelial bladder neoplasms (UBN) typically occur in patients in their sixth or seventh decade of life while they are infrequent in children and young adults. They occur in 0.1-0.4% of the population in the first two decades of life. Their management is controversial and paediatric guidelines are currently unavailable. OBJECTIVE To further expound the available data on the outcome of patients younger than 18 year old diagnosed with UBN. STUDY DESIGN We retrospectively reviewed the files of all the consecutive paediatric patients with UBN treated in three tertiary paediatric urology units from January 1999 to July 2013. Lesions were classified according to the 2004 WHO/ISUP criteria as urothelial papillomas (UP), papillary urothelial neoplasm of low malignant potential (PUNLMP), low-grade urothelial carcinoma (LGUC), and high-grade urothelial carcinoma (HGUC). RESULTS The table shows the results. Management after TURB varied among centres. One centre recommended only follow-up US at increasing intervals whereas another follow-up US plus urine cytologies and endoscopies, every three months in the first year, and at increasing intervals thereafter. After a median follow-up of 5 years (range 9 months-14.5 years), none of the patients showed disease recurrence or progression. DISCUSSION UBN is an uncommon condition in children and adolescents and, unlike in adults, its incidence, follow-up and outcome still controversial. Paediatric guidelines are currently lacking and management varies among centres. Gross painless haematuria is the most common presenting symptom. Therefore, this symptom should never be underestimated. US is generally the first investigation and additional imaging seems unnecessary. TURB often allows for complete resection. Lesions are generally solitary, non-muscle invasive, and low-grade (mainly UP and PUNLMP). Ideal follow-up protocol is the most controversial point. Reportedly, recurrence or progression during follow-up is uncommon in patients under 20 years, recurrence rate 7% and a single case of progression reported so far. Accordingly, a follow-up mainly based on serial US might be considered in this age group compared to adults where also serial endoscopies and urine cytologies are recommended. In the selection of the follow-up investigations, it should also be taken into consideration that urine cytology has a low sensibility in the detection of low-grade lesions while cystoscopy in young patients requires a general anaesthesia and hospitalization, and carries an increased risk of urethral manipulation. CONCLUSION UBN is a rare condition in children. Ultrasound is generally accurate in order to visualize the lesion, and TURB can treat the condition. Lesions are generally low-grade and non-muscle invasive, but high-grade lesions can also be detected. In present series, after TURB, follow-up US monitoring at increasing intervals was used at all centres, follow-up cystoscopies were added in two centres, but with different schedules. Urine cytologies were considered only at one centre. After a median follow-up of 5 years (range 9 months-14.5 years), none of the patients showed recurrence or progression of the disease.
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Affiliation(s)
- A Berrettini
- Department of Pediatric Urology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Commenda 10, 20122 Milano, Italy.
| | - M Castagnetti
- Section of Paediatric Urology, Urology Unit, Department of Oncological and Surgical Sciences, University Hospital of Padova, Via Giustiniani, 2, 35128 Padua, Italy.
| | - A Salerno
- Department Nephrology-Urology, Division of Pediatric Urology, 'Bambino Gesù' Children's Hospital Rome, IRCCS, Piazza S. Onofrio, 4, 00165 Roma, Italy.
| | - S G Nappo
- Department Nephrology-Urology, Division of Pediatric Urology, 'Bambino Gesù' Children's Hospital Rome, IRCCS, Piazza S. Onofrio, 4, 00165 Roma, Italy.
| | - G Manzoni
- Department of Pediatric Urology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Commenda 10, 20122 Milano, Italy.
| | - W Rigamonti
- Section of Paediatric Urology, Urology Unit, Department of Oncological and Surgical Sciences, University Hospital of Padova, Via Giustiniani, 2, 35128 Padua, Italy.
| | - P Caione
- Department Nephrology-Urology, Division of Pediatric Urology, 'Bambino Gesù' Children's Hospital Rome, IRCCS, Piazza S. Onofrio, 4, 00165 Roma, Italy.
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12
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Rifat UN, Hamadalla NY, Chiad Safi KC, Al Habash SS, Mohammed M. Urothelial bladder tumour in childhood: A report of two cases and a review. Arab J Urol 2014; 13:116-21. [PMID: 26413332 PMCID: PMC4561878 DOI: 10.1016/j.aju.2014.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Revised: 11/08/2014] [Accepted: 11/08/2014] [Indexed: 10/30/2022] Open
Abstract
Urothelial bladder tumour in childhood is extremely rare, and almost all the reported cases have been low-grade tumours with a favourable outcome. Here we review 57 reports comprising 127 cases, and we report two new cases.
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13
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Park S, Kim KS, Cho SJ, Lee DG, Jeong BC, Park KH, Baek M. Urothelial Tumors of the Urinary Bladder in Two Adolescent Patients: Emphasis on Follow-up Methods. Korean J Urol 2014; 55:430-3. [PMID: 24955230 PMCID: PMC4064054 DOI: 10.4111/kju.2014.55.6.430] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 09/10/2012] [Indexed: 11/18/2022] Open
Abstract
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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Affiliation(s)
- Sungchan Park
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Kun Suk Kim
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Suk Ju Cho
- Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea
| | - Dong-Gi Lee
- Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Byoung Chang Jeong
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwan Hyun Park
- Seoul Samsung Urology Clinic/Gynecology Health Care Center, Ulsan, Korea
| | - Minki Baek
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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14
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Bujons A, Caffaratti J, Garat JM, Villavicencio H. Long-term follow-up of transitional cell carcinoma of the bladder in childhood. J Pediatr Urol 2014; 10:167-70. [PMID: 24035638 DOI: 10.1016/j.jpurol.2013.08.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 08/06/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Bladder tumours are rare in children, with only 0.38% of cases occurring in the first two decades of life. OBJECTIVE To describe a long-term follow-up series of nine urothelial bladder tumours in children. PATIENTS AND METHODS We carried out a retrospective study covering the period from 1988 until 2005. We found that during this time, urothelial tumours had been diagnosed at our centre in eight patients (9 tumours) younger than 18 years old who reported an episode of haematuria. Diagnosis was attained through renal and bladder ultrasound in 85% of patients, and through cystoscopy under anaesthesia in 15%. All cases were treated by means of transurethral resection of the bladder, with ensuing follow-up using renal and bladder ultrasound and urinary cytology. MEASUREMENTS Patients characteristics and outcome are evaluated. RESULTS Single exophytic tumours were present in seven (87.5%) of the patients, located either in the lateral wall or in the trigone; one patient showed two small tumours. The pathology was as follows: two G1Ta, one G1T1, one G2T1, and five G2Ta. There were no recurrences. CONCLUSIONS Transitional cell carcinoma in childhood is of low grade and low aggressiveness. It has a good prognosis and recurrences are infrequent. We suggest performing a urinary cytology/cystoscopy every 6 months the first 2 years and urinary cytology/bladder ultrasound once a year.
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Affiliation(s)
- Anna Bujons
- Paediatric Urology Department, Fundació Puigvert, Barcelona, Spain.
| | - Jorge Caffaratti
- Paediatric Urology Department, Fundació Puigvert, Barcelona, Spain
| | - José Maria Garat
- Paediatric Urology Department, Fundació Puigvert, Barcelona, Spain
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Le carcinome urothélial des patients de moins de 40ans. Revue du comité de cancérologie de l’Association française d’urologie. Prog Urol 2013; 23:171-5. [DOI: 10.1016/j.purol.2012.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 11/13/2012] [Accepted: 12/02/2012] [Indexed: 11/18/2022]
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16
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Korrect GS, Minevich EA, Sivan B. High-grade transitional cell carcinoma of the pediatric bladder. J Pediatr Urol 2012; 8:e36-8. [PMID: 22105002 DOI: 10.1016/j.jpurol.2011.10.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 10/25/2011] [Indexed: 11/18/2022]
Abstract
Transitional cell carcinoma of the bladder is extremely rare in the first decade of life. We present the case of a 5-year-old male with gross hematuria found to have high-grade transitional cell carcinoma of the bladder. To our knowledge this is the first such reported case in this age group.
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Affiliation(s)
- Garrett S Korrect
- Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
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Urothelial neoplasms of the urinary bladder occurring in young adult and pediatric patients: a comprehensive review of literature with implications for patient management. Adv Anat Pathol 2011; 18:79-89. [PMID: 21169741 DOI: 10.1097/pap.0b013e318204c0cf] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Bladder urothelial carcinoma is typically a disease of older individuals and rarely occurs below the age of 40 years. There is debate and uncertainty in the literature regarding the clinicopathologic characteristics of bladder urothelial neoplasms in younger patients compared with older patients, although no consistent age criteria have been used to define "younger" age group categories. Use of the World Health Organization 2004/International Society of Urological Pathology 1998 grading nomenclature and recent molecular studies highlight certain unique features of bladder urothelial neoplasms in young patients, particularly in patients below 20 years of age. In this meta-analysis and review, the clinical, pathologic, and molecular features and risk factors of bladder urothelial neoplasms in patients 40 years or less are presented and analyzed according to decades of presentation. Similar to older patients, bladder urothelial neoplasms in patients 40 years or younger occur more common in male patients, present mainly with gross painless hematuria, and are more commonly located at bladder trigone/ureteral orifices, but in contrast have a greater chance for unifocality. Delay in diagnosis of bladder urothelial neoplasms seems not to be uncommon in younger patients probably because of its relative rarity and the predominance of benign causes of hematuria in this age group causing hesitancy for an aggressive work-up. Most tumors in patients younger than 40 years were low grade. The incidence of low-grade tumors was the lowest in the first 2 decades of life, with incremental increase of the percentage of high-grade tumors with increasing age decades. Classification according to the World Health Organization 2004/International Society of Urological Pathology grading system identified papillary urothelial neoplasms of low malignant potential to be relatively frequent among bladder tumors of young patients particularly in the teenage years. Similar to grade, there was marked predominance of low stage tumors in the first 2 decades of life with gradual inclusion of few higher stage and metastatic tumors in the 2 older decades. Bladder urothelial neoplasms occurring in patients <20 years of age lack or have a much lower incidence of aberrations in chromosome 9, FGFR3, p53, and microsatellite instability and have fewer epigenetic alterations. Tumor recurrence and deaths were infrequent in the first 2 decades and increased gradually in each successive decade, likely influenced by the increased proportion of higher grade and higher stage tumors. Our review of the literature shows that urothelial neoplasms of the bladder occurring in young patients exhibit unique pathologic and molecular features that translate to its more indolent behavior; this distinction is most pronounced in patients <20 years. Our overall inferences have potential implications for choosing appropriate noninvasive diagnostic and surveillance modalities, whenever feasible, and for selecting suitable treatment strategies that factor in quality of life issues vital to younger patients.
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