High-grade urothelial bladder cancer in children: A case report and critical analysis of the literature

Abstract

, Vladimir Student aBackground. Bladder cancer is relatively common in adults. In children, it is extremely rare and in the majority of cases, low grade, low stage urothelial cancers are found. Case report. We describe the diagnostic, therapeutic, and follow-up management of bladder cancer in a 3-year-old boy examined for painless hematuria. Transurethral resection of the tumor was performed and T1 high grade urothelial cancer with osseous metaplasia was found in definitive specimens. During the 2-year follow-up, there has been no recurrence. Typical characteristics of the most prevalent bladder tumors are presented. Conclusion. Despite its low incidence and low prevalence bladder cancer in children is a very serious condition which must not be missed in the differential diagnosis of hematuria or urinary tract infection. It is vital to differentiate urothelial cancer from hamartoma and nephrogenic adenoma and, particularly in osseous metaplasia, from sarcomatoid carcinoma. Especially in high-grade cancers, precise TUR of the tumor with a careful follow-up is essential to detect cancer recurrence and reduce progression.

Osseous Metaplasia of the Urinary Bladder:Mini Review of the Cases Reported After 1991

“…A series of 11 case reports matching our criteria were gathered (Table 1), available to be discussed [2,[4][5][6][7][8][9][10][11][12][13]. Our search was limited concerning the time period, beginning in 1991, as Eble and Young in that year published a review of the literature.…”

“…Computed tomography usually reveals calcification areas, while osseous metaplasia is confirmed after histological tumour biopsy examination, following curative transurethral tumour resection [2].…”

“…The cell nuclei often retain their normal orientation and round contour, while they are more pleomorphic and mitoses may be numerous. Papillary carcinoma is being presented as cauliflower or polypoid in shape tumour with superficial ulceration and necrosis and moderate architectural and cytologic atypia [2,13]. Angiosarcomas are an uncommon group of malignant neoplasms, characterized by rapidly proliferating, extensively infiltrating anaplastic cells derived from blood vessels, lining irregular blood-filled spaces [16].…”

“…Environmental background plays a significant role. Thus, smoking, infections (schistosoma haematobium), race, gender, arsenic in drinking water, occupational exposure to aromatic amines (products of the chemical, dye and rubber industries as well as hair dyes, paints, fungicides, cigarette smoke, plastics, metals and motor vehicle exhaust), are all well known risk factors for bladder cancer [2,3]. Osseous metaplasia is a rarely observed lesion in the stroma of bladder carcinoma, either in the primary tumour and/or in a metastasis [4].…”

Bladder cancer of the children and adolescents. Review of the literature and own clinical trial

“…Чешские коллеги во главе с M. Kral опубликовали случай РМП у 3-летнего мальчика, обследованного после эпизода дизурии в декабре 2013 г. [13]. В анализе мочи была обнаружена только умеренная микрогематурия.…”