Bladder urothelial cell carcinoma as a rare cause of haematuria in children: Our experience and review of current literature

Published:September 16, 2021DOI:https://doi.org/10.1016/j.jpedsurg.2021.09.007

      Abstract

      Objectives

      To report our experience of bladder urothelial cell carcinoma (UCC) in children and review contemporary management and follow-up of paediatric UCC.

      Patients and methods

      Between 2004 and 2020, five patients (4 boys and 1 girl) were managed at our centre for urothelial cell carcinoma of the bladder. Data was collected by note review for age at presentation, symptoms, clinical findings, investigations, treatment and follow-up.

      Results

      All five patients presented with visible haematuria, two had dysuria and one had suprapubic pain. Bladder ultrasound scan (USS) showed exophytic bladder lesions in only 4 patients. Definitive diagnosis and treatment were achieved by cystoscopic excision. Four patients had PUNLMP while one had Grade 3 pTa UCC of the bladder which required further cystoscopic excision and intravesical Mitomycin C (MMC) instillation. All patients were followed up clinically, with renal USS and cystoscopy. We have observed recurrence of the carcinoma in two patients requiring further cystoscopic excision and intravesical MMC.

      Conclusion

      Bladder urothelial cell carcinoma in children should be suspected in children presenting with haematuria. If renal USS is normal, cystoscopy should be considered for diagnosis and treatment. Compared to adults, children with bladder UCC often have favourable histopathology and prognosis. Close follow-up is necessary with renal USS and cystoscopy to detect recurrence even in PUNLMP.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal

      Subscribe:

      Subscribe to Journal of Pediatric Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Rezaee M.E.
        • Dunaway C.M.
        • Baker M.L.
        • Penna F.J.
        • Chavez D.R.
        Urothelial cell carcinoma of the bladder in pediatric patients: a systematic review and data analysis of the world literature.
        J Pediatr Urol. 2019; 15: 309-314https://doi.org/10.1016/j.jpurol.2019.06.013
        • Shelmerdine S.C.
        • Lorenzo A.J.
        • Gupta A.A.
        • Chavhan G.B.
        Pearls and pitfalls in diagnosing pediatric urinary bladder masses.
        Radiographics. 2017; 37: 1872-1891https://doi.org/10.1148/rg.2017170031
        • Javadpour N.
        • Mostofi F.K.
        Primary epithelial tumors of the bladder in the first two decades of life.
        J Urol. 1969; 101: 706-710https://doi.org/10.1016/s0022-5347(17)62407-8
        • Burger M.
        • Catto J.W.
        • Dalbagni G.
        Epidemiology and risk factors of urothelial bladder cancer.
        Eur Urol. 2013; 63: 234-241https://doi.org/10.1016/j.eururo.2012.07.033
        • Aguiar L.
        • Danialan R.
        • Kim C.
        A case of high-grade transitional cell carcinoma of the bladder in a pediatric patient with Turner syndrome.
        Urology. 2015; 85: 1477-1479https://doi.org/10.1016/j.urology.2014.12.038
        • Ghousheh A.I.
        • Durkee C.T.
        • Groth T.W.
        Advanced transitional cell carcinoma of the bladder in a 16-year-old girl with Hinman syndrome.
        Urology. 2012; 80: 1141-1143https://doi.org/10.1016/j.urology.2012.04.057
        • Urakami S.
        • Igawa M.
        • Shiina H.
        • Shigeno K.
        • Kikuno N.
        • Yoshino T.
        Recurrent transitional cell carcinoma in a child with the Costello syndrome.
        J Urol. 2002; 168: 1133-1134https://doi.org/10.1097/01.ju.0000024188.20748.1c
        • Dowling C.R.
        • Reddihough D.
        • Smith P.
        • Webb N.
        • McNeill R.
        • Clouston D.
        Transitional cell carcinoma in the paediatric population: be aware of unusual aetiologies.
        J Paediatr Child Health. 2007; 43: 773-775https://doi.org/10.1111/j.1440-1754.2007.01218.x
        • Oesterling J.E.
        • Epstein J.I.
        • Gearhart J.P.
        Transitional cell carcinoma of the bladder in an adolescent with Turner's syndrome.
        J Urol. 1987; 137: 398-400https://doi.org/10.1016/s0022-5347(17)44047-x
        • Gripp K.W.
        • Scott C.I.
        • Nicholson L.
        • Figueroa T.E.
        Second case of bladder carcinoma in a patient with Costello syndrome.
        Am J Med Genet. 2000; 90: 256-259https://doi.org/10.1002/(sici)1096-8628(20000131)90:3<256::aid-ajmg16>3.0.co;2-d
        • Schoemaker M.J.
        • Swerdlow A.J.
        • Higgins C.D.
        • Wright A.F.
        • Jacobs P.A.
        • UK Clinical Cytogenetics Group
        Cancer incidence in women with Turner syndrome in Great Britain: a national cohort study.
        Lancet Oncol. 2008; 9: 239-246https://doi.org/10.1016/S1470-2045(08)70033-0
        • Kilic N.
        • Turkel T.
        • Balkan E.
        • Sevinir B.
        Transitional cell carcinoma of the bladder presenting after blunt abdominal trauma: a very rare occurrence in childhood.
        Int J Urol. 2005; 12: 316-318https://doi.org/10.1111/j.1442-2042.2005.01035.x
        • Uçar M.
        • Demirkaya M.
        • Aytaç Vuruşkan B.
        • Balkan E.
        • Kılıç N.
        Urothelial carcinoma of the bladder in pediatric patient: four case series and review of the literature.
        Balk Med J. 2018; 35: 268-271https://doi.org/10.4274/balkanmedj.2017.1292
        • Hoenig D.M.
        • McRae S.
        • Chen S.C.
        • Diamond D.A.
        • Rabinowitz R.
        • Caldamone A.A.
        Transitional cell carcinoma of the bladder in the pediatric patient.
        J Urol. 1996; 156: 203-205
        • Bujons A.
        • Caffaratti J.
        • Garat J.M.
        • Villavicencio H.
        Long-term follow-up of transitional cell carcinoma of the bladder in childhood.
        J Pediatr Urol. 2014; 10: 167-170https://doi.org/10.1016/j.jpurol.2013.08.002
        • Lerena J.
        • Krauel L.
        • García-Aparicio L.
        • Vallasciani S.
        • Suñol M.
        • Rodó J.
        Transitional cell carcinoma of the bladder in children and adolescents: six-case series and review of the literature.
        J Pediatr Urol. 2010; 6: 481-485https://doi.org/10.1016/j.jpurol.2009.11.006
        • Paner G.P.
        • Zehnder P.
        • Amin A.M.
        • Husain A.N.
        • Desai M.M.
        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: 79-89https://doi.org/10.1097/PAP.0b013e318204c0cf
        • Schraml J.
        • Silva J.D.C.
        • Babjuk M.
        Current concept of transurethral resection of bladder cancer: from re-transurethral resection of bladder cancer to en-bloc resection.
        Curr Opin Urol. 2018; 28: 591-597https://doi.org/10.1097/MOU.0000000000000542
        • Kim L.H.C.
        • Patel M.I.
        Transurethral resection of bladder tumour (TURBT).
        Transl Androl Urol. 2020; 9: 3056-3072https://doi.org/10.21037/tau.2019.09.38
        • Huang H.
        • Li X.
        • Jin J.
        Treatment of bladder transitional cell carcinoma in children: a single center experience from China.
        Arch Iran Med. 2015; 18: 250-252
        • Marinoni F.
        • Destro F.
        • Selvaggio G.G.O.
        • Riccipetitoni G.
        Urothelial carcinoma in children: a case series.
        Bull Cancer. 2018; 105: 556-561https://doi.org/10.1016/j.bulcan.2018.03.002
        • Saltsman J.A.
        • Malek M.M.
        • Reuter V.E.
        Urothelial neoplasms in pediatric and young adult patients: a large single-center series.
        J Pediatr Surg. 2018; 53: 306-309https://doi.org/10.1016/j.jpedsurg.2017.11.024
        • Marte A.
        Transitional cell carcinoma of the bladder in children long term follow-up.
        Austin J Urol. 2016; 3: 1039
        • Park S.
        • Kim K.S.
        • Cho S.J.
        Urothelial tumors of the urinary bladder in two adolescent patients: emphasis on follow-up methods.
        Korean J Urol. 2014; 55: 430-433https://doi.org/10.4111/kju.2014.55.6.430
      1. Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer: AUA/SUO joint guideline. 2016. https://www.auanet.org/guidelines/bladder-cancer-non-muscle-invasive-guideline

        • Di Carlo D.
        • Ferrari A.
        • Perruccio K.
        Management and follow-up of urothelial neoplasms of the bladder in children: a report from the TREP project.
        Pediatr Blood Cancer. 2015; 62: 1000-1003https://doi.org/10.1002/pbc.25380