J Korean Med Sci.  2018 Oct;33(40):e242. 10.3346/jkms.2018.33.e242.

Clinicopathological Characteristics of Urinary Bladder Tumors in Korean Patients 20 Years or Younger

Affiliations
  • 1Department of Urology, Inje University, Haeundae Paik Hospital, Busan, Korea.
  • 2Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. scpark@amc.seoul.kr
  • 3Department of Urology, Asan Medical Center, University of Ulsan Collage of Medicine, Seoul, Korea.

Abstract

BACKGROUND
To investigate the clinicopathological characteristics of urinary bladder tumors, a rare malignancy, in patients 20 years or younger.
METHODS
Using a retrospective chart review among patients who received bladder surgery at 2 institutions between July 1996 and January 2013, we analyzed the clinicopathological characteristics of urinary bladder tumors in 21 pediatric patients (male:female = 4.25:1.00; mean age, 12.1 years).
RESULTS
Pathology revealed 9 urothelial tumors, 6 rhabdomyosarcomas, 1 low-grade leiomyosarcoma, 1 large cell neuroendocrine carcinoma, 1 inflammatory myofibroblastic tumor, and 3 cases of chronic inflammation without tumors (including 1 xanthogranulomatous inflammation). Urothelial tumors (mean patient age, 16.0 years) were benign or low-grade; and only transurethral resection of the bladder tumor was necessary for treatment. Patients with rhabdomyosarcomas (mean age, 5 years) underwent radiotherapy (if unresectable) or transurethral resection of the bladder tumor (if resectable), after chemotherapy. Of these patients, 2 underwent radical cystectomy, with the remaining patients not receiving a cystectomy. With the exception of one patient, all patients are currently alive and recurrence-free.
CONCLUSION
Urothelial tumors were the most commonly found pediatric bladder tumor, with embryonal rhabdomyosarcoma being the second most common. Urothelial tumors are common in relatively older age. Since urothelial tumors in children typically have a good prognosis and rarely recur, transurethral resection of the bladder tumor is the treatment of choice. Rhabdomyosarcomas are common in younger patients. Since rhabdomyosarcoma is generally chemosensitive, chemotherapy and radiotherapy are the treatment of choice for bladder preservation in these patients.

Keyword

Urinary Bladder Tumor; Pediatric Patients; Surgery; Pathology; Cystectomy

MeSH Terms

Carcinoma, Neuroendocrine
Child
Cystectomy
Drug Therapy
Humans
Inflammation
Leiomyosarcoma
Myofibroblasts
Pathology
Prognosis
Radiotherapy
Retrospective Studies
Rhabdomyosarcoma
Rhabdomyosarcoma, Embryonal
Urinary Bladder Neoplasms
Urinary Bladder*
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