Urothelial neoplasms in patients 20 years or younger: a clinicopathological analysis using the world health organization 2004 bladder consensus classification
- PMID: 16217372
- DOI: 10.1097/01.ju.0000176801.16827.82
Urothelial neoplasms in patients 20 years or younger: a clinicopathological analysis using the world health organization 2004 bladder consensus classification
Abstract
Purpose: Urothelial neoplasms in patients younger than 20 years are rare, with conflicting data regarding clinical outcomes.
Materials and methods: We identified 23 patients 4 to 20 years old with urothelial neoplasms, reclassified the microscopic diagnoses using the 2004 WHO/International Society of Urologic Pathology grading classification and collected data on presentation, risk factors and outcomes.
Results: Pathological grading revealed 2 urothelial papillomas, 10 papillary urothelial neoplasms of low malignant potential (PUNLMPs), and 8 low grade and 3 high grade papillary urothelial cancers, all without invasion. Mean patient age was 13.2 years (range 4 to 20), 19 patients were male and 19 presented with gross hematuria. All lesions were solitary and measured 0.1 to 6 cm. One patient had a history of smoking and 1 had parents who smoked. Three patients (13%) had recurrences classified as either urothelial papilloma (1) or PUNLMP (2). All patients were alive with no evidence of disease after a mean followup of 4.5 years (range 6 months to 13 years).
Conclusions: Urothelial neoplasms in individuals younger than 20 years more commonly occur in males and are predominantly low grade with a favorable clinical outcome. Before the current classification system the 10 patients with a diagnosis of PUNLMP would have been classified as having papillary carcinoma. Thus, the diagnostic category of PUNLMP allowed 43.5% of patients in this series to avoid being labeled with "cancer" at a young age.
Similar articles
-
Comparison of the WHO/ISUP classification and cytokeratin 20 expression in predicting the behavior of low-grade papillary urothelial tumors. World/Health Organization/Internattional Society of Urologic Pathology.Mod Pathol. 2001 Apr;14(4):267-72. doi: 10.1038/modpathol.3880300. Mod Pathol. 2001. PMID: 11301341
-
Comparison of american joint committee on cancer pathological stage T2a versus T2b urothelial carcinoma: analysis of patient outcomes in organ confined bladder cancer.J Urol. 2009 Feb;181(2):540-5; discussion 546. doi: 10.1016/j.juro.2008.10.038. Epub 2008 Dec 13. J Urol. 2009. PMID: 19084855
-
Flat intraepithelial lesions of the urinary bladder.Cancer. 2000 Feb 1;88(3):625-31. Cancer. 2000. PMID: 10649257
-
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 Jan;18(1):79-89. doi: 10.1097/PAP.0b013e318204c0cf. Adv Anat Pathol. 2011. PMID: 21169741 Review.
-
Non-invasive papillary urothelial neoplasms: the 2004 WHO/ISUP classification system.Pathol Int. 2010 Jan;60(1):1-8. doi: 10.1111/j.1440-1827.2009.02477.x. Pathol Int. 2010. PMID: 20055945 Review.
Cited by
-
Urothelial neoplasms in pediatric and young adult patients: A large single-center series.J Pediatr Surg. 2018 Feb;53(2):306-309. doi: 10.1016/j.jpedsurg.2017.11.024. Epub 2017 Nov 14. J Pediatr Surg. 2018. PMID: 29221636 Free PMC article.
-
Urothelial tumors of the urinary bladder in young patients: a clinicopathologic study of 59 cases.Arch Pathol Lab Med. 2013 Oct;137(10):1337-41. doi: 10.5858/arpa.2012-0322-OA. Arch Pathol Lab Med. 2013. PMID: 24079760 Free PMC article.
-
Non-muscle invasive urothelial bladder cancer in a 17-year-old male: A rare case report.Int J Surg Case Rep. 2023 Sep;110:108728. doi: 10.1016/j.ijscr.2023.108728. Epub 2023 Aug 29. Int J Surg Case Rep. 2023. PMID: 37683512 Free PMC article.
-
Urothelial carcinoma of the urinary bladder in pediatric patients: a long-term follow-up.Int Urol Nephrol. 2015 May;47(5):771-4. doi: 10.1007/s11255-015-0950-z. Epub 2015 Mar 19. Int Urol Nephrol. 2015. PMID: 25787072
-
Clinicopathological Characteristics of Urinary Bladder Tumors in Korean Patients 20 Years or Younger.J Korean Med Sci. 2018 Aug 13;33(40):e242. doi: 10.3346/jkms.2018.33.e242. eCollection 2018 Oct 1. J Korean Med Sci. 2018. PMID: 30275804 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical