[Urothelial tumors in children]

Area of Science:

• Urology
• Pediatric Oncology
• Pathology

Background:

• Urothelial tumors are exceptionally rare in children, with approximately 150 cases reported globally.
• These tumors constitute only a small fraction of childhood malignancies, with 20% occurring before age ten.
• The World Health Organization/International Society of Urological Pathology (WHO/ISUP) classification guides the understanding of these rare pediatric lesions.

Purpose of the Study:

• To delineate the clinicopathologic characteristics of urothelial tumors in pediatric patients.
• To highlight the distinct treatment considerations for urothelial tumors in the young population.
• To provide insights into the diagnosis, management, and prognosis of pediatric urothelial neoplasms.

Main Methods:

• Review of clinicopathologic features based on the WHO/ISUP consensus classification.
• Analysis of tumor location, presentation, and diagnostic modalities including ultrasound and cystoscopy.
• Evaluation of treatment strategies, primarily transurethral resection, and follow-up protocols.

Main Results:

• Pediatric urothelial tumors are predominantly low-grade, non-invasive papillary lesions.
• A male predominance is observed, with a sex ratio of 3:1 (boys to girls).
• The primary symptom is macroscopic hematuria, necessitating ultrasound; cystoscopy with biopsy confirms diagnosis.
• Tumors are most frequently found in the bladder, particularly on the posterior or lateral walls.

Conclusions:

• Pediatric urothelial tumors, often non-invasive, generally have a better prognosis than in adults.
• While recurrences can occur, invasive carcinomas with metastases are rare but possible.
• Standardized monitoring protocols are needed due to the rarity of these tumors in children.