Saltsman JA, et al. - Researchers here presented their institutional experience with bladder urothelial neoplasms in pediatric and young adult patients summarizing presentation, treatment, and outcomes. They recognized hematuria as the most common sign of bladder neoplasia in children and young adults and recommended investigating it by cystoscopy. In these patients, the majority of urothelial neoplasms were noninvasive and could be successfully treated with transurethral resection.

Methods

• Researchers searched surgical pathology records at their institution for cases of urothelial neoplasms among patients ≤25 years of age treated between January 1997 and September 2016.
• They excluded cases submitted exclusively for pathology review.
• Pathologic examination using the 2004 World Health Organization classification system confirmed the diagnoses.

Results

• Researchers identified 34 patients; a mean age was 21.1 years (range 8–25 years).
• Median follow-up of 25.1 months (1–187 months) was performed.
• The male to female ratio of 1.83:1 was observed.
• Hematuria was identified as the most common presenting symptom(n=26; 76%).
• In this study, diagnoses were invasive urothelial carcinoma (n=3), noninvasive urothelial carcinoma (n=24), PUNLMP (n=6), and urothelial papilloma (n=1).
• Noninvasive lesions were resected by cystoscopy; complications (grade II or greater) occurred in 12% (n=4).
• Death of 1 patient with stage IV invasive disease at diagnosis was reported.
• Recurrences developed in 2 patients.
• Twenty-nine percent (n=7) underwent repeat cystoscopy soon after initial TURBT at outside institutions, and 17% (n=4) had tumors downgraded from high-grade to low-grade after pathology review, among those with noninvasive carcinoma.