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Category: Volume 06 Issue 08 August 2018
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Title: Bladder Tumor in Young Boy: A Rare Case Report

Authors: Dr Sumit Gupta, Dr Piyush Aggarwal, Dr Kh Somarendra

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i8.153

Abstract

Introduction: Bladder cancer below the age of 20 years old is not only rare, with an approximated total of 125 cases being collected worldwide by 2010 but it has also been defined as clinico-pathologically distinct from bladder tumors in older age groups. As benign causes of frank hematuria are more common in this age group than tumors, this often leads to a considerable delay in the diagnosis. With this case we would like to emphasize that bladder tumor should be consider in the diagnosis for evaluation of causes for hematuria in younger age groups.

Case Report: We present a case of 15 year old boy who came to us with on and off hematuria since 4 months with occasional passage of clots. No other significant history. No family history of malignancy. No history of smoking. On examination- he had pallor, dehydration and suprapubic tenderness. He was admitted and received 4 units of PRBC for hemodynamic stabilization.

A microscopy and culture test of his urine confirmed his urine to be sterile and urine cytology was negative for malignant cells. On further workup USG showed 5.2x3cm Urinary Bladder growth in right postero-inferior wall suggesting urinary bladder tumor. CECT revealed small polypoidal irregular soft tissue mass in posterolateral wall of urinary bladder and no evidence of any upper tract abnormality, lymph nodes or metastases. He underwent TURBT under spinal anesthesia and perioperative periods were uneventful. HPE reported as low grade papillary urothelial cancer. He was discharged with follow up advice.

Conclusion: Despite its low incidence in children, TCCB must be suspected in the event of macroscopic haematuria. Ultrasound followed by cystoscopy are the ideal diagnostic tools for visualization of these tumours. Follow up must be clinical with periodic ultrasound evaluation. Periodic cystoscopy is indicated only in cases of clinical or ultrasonographic suspicion of recurrence.

Discussion: Neither physical examination nor laboratory analysis revealed any significant abnormalities, but ultrasound showed polypoidal intravesical lesions. Surgical resection was performed endoscopically. 

References

  1. 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;6:481–485.
  2. Paner G.P., Zehnder P., Amin A.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; 18:79–89.
  3. Alanee S., Shukla A.R. Bladder malignancies in children aged <18 years: results from the Surveillance, Epidemi-ology and End Results database. BJU Int. 2010;106:557–560.
  4. Greenfield S.P., Williot P., Kaplan D. Gross hematuria in children: a ten-year review. Urology. 2007;69:166–169.
  5. Resnick MJ, Bassett JC, Clark PE. Management of superficial and muscle-invasive urothelial cancers of the bladder. Curr 2013;25:281–288.
  6. Yusim I, Lismer L, Greenberg G, Haomud K, Kaneti J. Carcinoma of the bladder in patients under 25 years of age. Scand J Urol Nephrol. 1996;30:461–463. doi: 10.3109/00365599609182324.
  7. Fine SW, Humphrey PA, Dehner LP, Amin MB, Epstein JL. Urothelial neoplasms in patients 20 years or younger: a clinicopathological analysis using the world health organization 2004 bladder consensus classification. J Urol. 2005;174: 1976–1980.
  8. Paner GP, Zehnder P, Amin AM, Husain AN, Desai MM. Urothelial neoplasms of the urinarybladder occurring in young adult and pediatric patients: a comprehensive review of literature with implications for patient management. Adv Anat Pathol. 2011;18:79–89.
  9. Yossepowitch O, Dalbagni G. Transitional cell carcinoma of the bladder in young adults: presentation, natural history and outcome. J Urol. 2002;168:61–66.
  10. Lezama–del Valle P, Jerkins GR, Rao BN, Santana VM, Fuller C, Merchant TE. Aggressive bladder carcinoma in a child. Pediatr Blood Cancer. 2004;43:285–288.
  11. Scott AA, Stanley W, Worsham GF, Kirkland TA, Jr, Gansler T, Garvin AJ. Aggressive bladder carcinoma in an adolescent. Report of a case with immunohistochemical, cytogenetic, and flow cytometric characterization. Am J Surg Pathol. 1989;13:1057–1063.
  12. Mueller CM, Caporaso N, Greene MH. Familial and genetic risk of transitional cell carcinoma of the urinary tract. Urol Oncol. 2008;26:451–464.
  13. Ristiċ-Petroviċ A, Stojnev S, Jankoviċ-Velickoviċ L, Marjanoviċ G. Malakoplakia mimics urinarybladder cancer: A case report. Vojnosanit Pregl. 2013;70:606–608.
  14. Gedikoğlu G, Sӧkmensüer C, Sӧylemezoğlu F, Koçal C. Carcinosarcoma of the urinary bladder. IntUrolNephrol. 1996;28:333–336.

Corresponding Author

Dr Sumit Gupta

Mch Urology Student