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Transitional cell carcinoma of the bladder in the pediatric patient
D M Hoenig1, S McRae, S C Chen
1Division of Urology, Brown University, Providence, Rhode Island, USA.
Insights
Transitional cell carcinoma of the bladder is rare in children. Bladder ultrasound is a sensitive tool for diagnosing this cancer, aiding in minimally invasive surveillance.
Area of Science:
- Pediatric Urology
- Oncology
Background:
- Transitional cell carcinoma (TCC) of the bladder is exceptionally rare in pediatric patients.
- Early diagnosis and effective management are crucial for improving outcomes in pediatric oncology.
Purpose of the Study:
- To report on five pediatric cases of transitional cell carcinoma of the bladder.
- To describe diagnostic characteristics and review literature on this rare condition.
- To define challenges in diagnosis, treatment, and follow-up for pediatric TCC.
Main Methods:
- Case series of five male patients aged 11-18 years with bladder TCC.
- Correlation of preoperative imaging and urinary cytology with cystoscopic and biopsy findings.
- Evaluation of diagnostic sensitivity of bladder ultrasound.
Main Results:
- Gross hematuria was the presenting symptom in all patients.
- Lesions were low-grade with definitive cystoscopic management and low recurrence rates.
- Preoperative imaging detected tumors in all cases; bladder ultrasound showed 100% sensitivity.
Conclusions:
- Pediatric bladder TCC poses diagnostic and follow-up challenges, often requiring general anesthesia for cystoscopy.
- Bladder ultrasound is a highly sensitive and minimally invasive tool for lesion identification and surveillance in pediatric patients.
- Early detection and appropriate management strategies are key for this rare pediatric malignancy.
Purpose:
We report on 5 boys with transitional cell carcinoma of the bladder, describe the identifying characteristics, review the literature, and define the issues of diagnosis, treatment and followup in this rare disease in pediatric patients.
Materials And Methods:
Five boys 11 to 18 years old were identified with transitional cell carcinoma of the bladder. Preoperative imaging and urinary cytology were correlated with cystoscopic and biopsy findings.
Results:
In all patients evaluation was prompted by gross hematuria. Low grade lesions, definitive cystoscopic management and a low recurrence rate were uniform findings. Preoperative imaging identified the tumor in all cases and bladder ultrasound was the most sensitive scan with 4 of 4 cases identified.
Conclusions:
While rare, transitional cell carcinoma of the bladder in children presents a challenge in diagnosis and followup since cystoscopy typically requires general anesthesia in this age group. Bladder ultrasound was found to be extremely sensitive in identifying lesions, and it may be a valuable and minimally invasive surveillance tool.