Recurrent bladder papilloma in a child with Cushing's syndrome. Case report

A case of bladder papilloma in a 12-year-old boy with Cushing's syndrome was reported by us in 1975. A walnut-sized papilloma was removed by transvesical extirpation, and bilateral adrenalectomy was performed. Two years later he was reoperated because of recurrent Cushing syndrome, and at the same time he had a recurrence of multiple bladder papillomas. Since removal of residual adrenocortical tissue and hormone substitution therapy his Cushing appearance has disappeared completely. The recurrent papillomas were removed by transurethral electrocoagulation and control cystoscopies have shown no sign tumour recurrence. We suggest a possible neoplastic effect of some tryptophan metabolites(s) in combination with immunosuppression as the cause of the bladder papillomas.