Urothelial Carcinoma in Pediatric Patient

Abstract

Transitional cell carcinoma as a cause of hematuria is a rare entity in the pediatric age group. An 11-year-old child presented with gross, painless hematuria. Ultrasonogram and computed tomography scan of the child revealed a tumor in the posterolateral wall of the bladder. Cystoscopically, the mass was present in the bladder away from the trigone area about 2 cm lateral to the right ureteric orifice. Transurethrally, the tumor was excised by a cystoscope. Histopathologically, it was a low-grade noninvasive urothelial carcinoma of the bladder. A follow-up cystoscopy at 6 months and 1 year had no recurrence. Literature review revealed the pediatric age group as an uncommon age for urothelial carcinoma of bladder, which has a different biological behavior of being low malignant potential compared to their adult counterpart. They have been treated with transurethral resection of bladder tumor without any adjuvant therapy. There is no definite follow-up schedule for these tumors as it occurs in very small number of cases.

Keywords: Bladder carcinoma; Low-grade urothelial carcinoma; Pediatric bladder tumor; Urothelial carcinoma.

Fig. 1

CECT scan of the abdomen showing the enhancing tumor (arrow mark) in the posterior wall of the urinary bladder

Fig. 2

Cystoscopic view of the urinary bladder tumor (a, b) showing polypoidal luminal growth. Histopathology of the mass is showing intact lamina propria (c, d) with enlarged crowded nuclei suggestive of low-grade papillary urothelial carcinoma