Objectives

To report our experience of bladder urothelial cell carcinoma (UCC) in children and review contemporary management and follow-up of paediatric UCC.

Patients and methods

Between 2004 and 2020, five patients (4 boys and 1 girl) were managed at our centre for urothelial cell carcinoma of the bladder. Data was collected by note review for age at presentation, symptoms, clinical findings, investigations, treatment and follow-up.

Results

All five patients presented with visible haematuria, two had dysuria and one had suprapubic pain. Bladder ultrasound scan (USS) showed exophytic bladder lesions in only 4 patients. Definitive diagnosis and treatment were achieved by cystoscopic excision. Four patients had PUNLMP while one had Grade 3 pTa UCC of the bladder which required further cystoscopic excision and intravesical Mitomycin C (MMC) instillation. All patients were followed up clinically, with renal USS and cystoscopy. We have observed recurrence of the carcinoma in two patients requiring further cystoscopic excision and intravesical MMC.

Conclusion

Bladder urothelial cell carcinoma in children should be suspected in children presenting with haematuria. If renal USS is normal, cystoscopy should be considered for diagnosis and treatment. Compared to adults, children with bladder UCC often have favourable histopathology and prognosis. Close follow-up is necessary with renal USS and cystoscopy to detect recurrence even in PUNLMP.

中文翻译：

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膀胱尿路上皮细胞癌作为儿童血尿的罕见原因：我们的经验和对当前文献的回顾

目标

报告我们在儿童膀胱尿路上皮细胞癌 (UCC) 中的经验，并回顾儿科 UCC 的当代管理和随访。

患者和方法

2004 年至 2020 年间，5 名患者（4 名男孩和 1 名女孩）在我们的膀胱尿路上皮细胞癌中心接受治疗。通过对就诊年龄、症状、临床发现、调查、治疗和随访的记录进行审查来收集数据。

结果

所有 5 名患者均出现可见血尿，2 名出现排尿困难，1 名出现耻骨上疼痛。膀胱超声扫描 (USS) 仅在 4 名患者中显示外生性膀胱病变。通过膀胱镜切除术获得明确诊断和治疗。4 名患者患有 PUNLMP，1 名患有 3 级 pTa UCC 膀胱，需要进一步膀胱镜切除和膀胱内丝裂霉素 C (MMC) 滴注。对所有患者进行临床随访，包括肾脏超声和膀胱镜检查。我们观察到两名需要进一步膀胱镜切除和膀胱内 MMC 的患者的癌症复发。

结论

出现血尿的儿童应怀疑儿童膀胱尿路上皮细胞癌。如果肾脏 USS 正常，应考虑膀胱镜检查进行诊断和治疗。与成人相比，患有膀胱 UCC 的儿童通常具有良好的组织病理学和预后。即使在 PUNLMP 中，也需要通过肾脏 USS 和膀胱镜检查来密切随访以检测复发。