Transurethral needle biopsy: a novel technique for pathologic diagnosis of bladder tumors in children

Trans-Urethral Snare of Bladder Tumor (TUSnBT) with Stone Basket Retrieval: A Novel Time-Saving Technique in the Endoscopic Management of Papillary Bladder Lesions

Background

To assess if trans-urethral snare of bladder tumor (TUSnBT) with subsequent stone basket retrieval can be used as an effective, time-saving adjunct resection technique for papillary bladder lesions.

Methods

Via standard cystoscopy, TUSnBT was performed using a standard endoscopic polypectomy snare with subsequent tumor extraction utilizing a standard stone retrieval basket, when lesions were more than 10 mm in diameter. Smaller lesions were removed with the polypectomy snare. Standard trans-urethral resection of bladder tumors (TURBT) of the tumor bed was performed post TUSnBT. Histological assessment was performed and assessed separately per session.

Results

In total, 18 papillary lesions, measuring between 9 and 26 mm, were resected via TUSnBT. Operative TUSnBT time, ranged between 10 and 60 seconds duration per lesion. No significant postoperative morbidity was experienced by patients within this cohort. Histo-pathological assessment revealed adequate muscle representation in 83.3 % of TUSnBT grouped sessions assessed.

Conclusion

TUSnBT with stone retrieval basket retrieval is a feasible method in selected papillary bladder lesions, and may be coupled with standard TURBT resection techniques. This method is less time consuming and would prove beneficial in select lesions. It may also be beneficial to assist with reducing the resection time or inadvertent bladder perforation encountered during the conventional TURBT.

The First Report of Urothelial (Clear Cell Variant) Bladder Cancer in a Child

Urothelial bladder tumours in childhood are extremely rare, with most cases being low grade, superficial disease of the papillary subtype with favourable outcomes. Urothelial (clear cell variant) carcinoma of bladder (UCCVCB) is an exceptional histological finding in both the adult and paediatric population. Herein we describe the first case of UCCVCB diagnosed in childhood. With this case being only the fourth report of confirmed muscle invasion in childhood, we discuss the entity of UCCVCB, and furthermore review all previously reported confirmed cases of childhood muscle invasive urothelial bladder cancer, in general.