Transitional Cell Carcinoma Of The Bladder In Children And Adolescents: 5-Case Series
PURPOSE Lower urinary tract tumours are very rare in paediatric age. Among them, transitional cell carcinoma of the bladder (TCCB) is even less frequent in the first two decades of life and exceptional under 10 years of age. The present series aims to expand the reported cases in literature. MATERIAL AND METHODS Between 1984 and 2006, four patients (4 male, 1 female) were treated in our Center. Their ages were 6, 9, 13, 14 and 17 years old. Clinical presentation was macroscopic hematuria in 4 and pielonefritis in one. Physical examination, laboratory analysis, ultrasound and cistoscopy were performed in all patients before surgical treatment. Follow up was ensured by clinical and ultrasound assessment. RESULTS Physical examination and laboratory analysis did not revealed any significant result. By the other hand, ultrasound showed exophytical intravesical lesions. Surgical resection was performed endoscopically. Anatomopatological studies showed grade I TCCB in all cases. Immediate postoperative period was uneventful and long term follow up did not revealed recurrence. CONCLUSIONS Even its low incidence in pediatric age, TCCB must be suspected in the event of macroscopic hematuria. Ultrasound first and cistoscopy later are the ideal diagnostic tools for visualisation of these tumours. Endoscopical resection, in the present series, has been demonstrated as effective in all cases. Follow up must be clinical with periodical ultrasound evaluation. Urine cytologic examination is doubtful effective. Periodical cystoscopy is indicated only in cases of clinical or ultrasonografic suspicion of recurrence.