Urothelial neoplasm in a 19-year-old male patient with urine discoloration, negative lab, and imaging workup: Should we investigate the findings or the symptom?

Abstract

With few cases of PUNLMPs in young adults being reported in the literature, we hope to raise clinical awareness of prompt and effective diagnosis, while maintaining a high index of suspicion among health professionals. Even in the absence of red blood cells in the urine and subsequent negative imaging workup, clinicians should not delay performance of diagnostic cystoscopy.

Keywords: PUNLMP; TURBT; bladder; papillary; young.

Figure 1

Axial view of first CT Urography (CTU), without any intravesical papillary mass or indication of filling defect

Figure 2

Image of transabdominal ultrasound of the bladder, failing to demonstrate intravesical papillary mass

Figure 3

Axial view of second CT Urography (CTU) 6 mo later, indicating the absence of papillary lesion inside the bladder