Bladder Neoplasia in Pediatric Patients-A Single-Center Experience Including a Case Series.

Area of Science:

• Urology
• Pediatric Oncology
• Pathology

Background:

• Bladder tumors are uncommon in pediatric patients, with urothelial carcinoma being particularly rare.
• Painless hematuria is a significant clinical presentation in pediatric bladder lesions.
• Diagnostic procedures like bladder biopsy and urinary cytology are infrequently required in children.

Purpose of the Study:

• To analyze the incidence and characteristics of urothelial neoplasms in pediatric bladder lesions.
• To review clinical presentation, diagnostic methods, and treatment outcomes for pediatric bladder tumors.
• To identify potential genetic markers and compare findings with adult urothelial neoplasms.

Main Methods:

• Retrospective analysis of surgical pathology records from 1984-2014.
• Inclusion of cases of urothelial neoplasms in pediatric patients.
• Pathologic confirmation using the 2004 World Health Organization (WHO) classification system.
• Literature review for diagnostic staging, treatment, and follow-up recommendations.

Main Results:

• Five tumors were identified among 287 bladder specimens: two urothelial tumors and three rhabdomyosarcomas.
• One urothelial tumor was a papillary urothelial neoplasm of low malignant potential (PUNLMP) with a 9p21 deletion.
• The second urothelial lesion was a fibroepithelial polyp; rhabdomyosarcoma was the most common malignant tumor.
• Painless hematuria was the primary symptom in the reported cases.

Conclusions:

• Pediatric bladder tumors are rare, predominantly urothelial and mesenchymal types.
• Rhabdomyosarcoma is the most frequent malignant bladder tumor in childhood.
• The 9p21 deletion is implicated in pediatric urothelial neoplasms, similar to adults.
• Standardized treatment protocols for pediatric bladder tumors are still lacking.