CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2020; 29(02): 091-095
DOI: 10.1055/s-0039-3402486
Original Article | Artículo Original
Urologic Oncology/Urología Oncológica
Sociedad Colombiana de Urología. Publicado por Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Transitional Cell Carcinoma of the Bladder in Pediatric Patients: Where Do We Stand?

Carcinoma de células transicionales de vejiga en pacientes pediatricos: ¿Dónde nos encontramos?
Jaime Perez
1   Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
2   Department of Urology, Fundación Santa Fe de Bogotá, Colombia
,
Julián Chavarriaga
1   Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
,
Paula Peña
1   Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
,
Gustavo Ramos
1   Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
4   Division of Urology, Instituto Nacional de Cancerología, Bogotá, Colombia
,
Lynda Torres
1   Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
,
Alejandra Bravo
2   Department of Urology, Fundación Santa Fe de Bogotá, Colombia
,
Paola Orrego
1   Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
,
Nicolás Fernandez
1   Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
2   Department of Urology, Fundación Santa Fe de Bogotá, Colombia
3   Division of Urology, Hospital for Sick Children (SickKids), University of Toronto, Canada
› Institutsangaben
Weitere Informationen

Publikationsverlauf

01. September 2019

04. November 2019

Publikationsdatum:
07. Februar 2020 (online)

Abstract

Introduction Transitional cell carcinoma of the bladder (TCCB) is uncommon in the pediatric population, and its etiology, natural history and epigenetics remain poorly understood. We aim to describe six cases of TCCB in pediatric patients and discuss the state of the art in the management and follow-up of the patients with this uncommon early presentation.

Methods The clinicopathological data of 6 patients with TCCB who underwent transurethral resection of bladder tumor (TURBT) were obtained from our institutional database. The patient data were collected retrospectively. A review of the literature was performed, and the most relevant and trending data were analyzed.

Results A total of 6 patients (4 female, 2 male) were treated at our institution between 2004 and 2019. The mean age of the sample was 12 years, and the presenting symptoms were macroscopic hematuria (3 cases), suprapubic pain (2 cases), and 1 case was an incidental finding during pelvic ultrasonography. The long-term follow-up (median follow-up of 61 months) did not reveal recurrence.

Conclusion Transitional cell carcinoma of the bladder rarely presents in the pediatric population. Genetic and epigenetic anomalies have been proposed as causes, as well as carcinogenic exposure. The reported cases tend to have a good prognosis, and most are non-invasive at the diagnosis. Follow-up protocols are still lacking, as well as molecular insights on tumor development and prognostic markers.

Resumen

Introducción Carcinoma de células transicionales de vejiga (CCTV) es una patología rara en la población pediátrica, su etiología, historia natural y epigenetica son pobremente entendidos. El objetivo de este articulo es describir 6 casos de CCTV en pacientes pediátricos, discutir el estado del arte en el manejo y seguimiento de los pacientes.

Métodos Los datos clinicopatologicos de 6 pacientes con CCTV sometidos a resección transuretral de tumor vesical (RTU-TV) se analizaron de nuestra base de datos institucional. Los datos fueron recolectados y analizados de manera retrospectiva. Se realizo una revisión de la literatura y solo los artículos mas relevantes fueron analizados.

Resultados Un total de 6 pacientes (4 mujeres, 2 hombres) fueron tratados en nuestra institución entre el 2004 y el 2019. La media de edad fue 12 años y los síntomas mas frecuentes fueron hematuria macroscópica (3 casos), dolor suprapúbico (2 casos) y en un caso fue un hallazgo incidental durante una ultrasonografía pélvica. El seguimiento a largo plazo (mediana de seguimiento de 61 meses) no mostro recurrencia en ningún paciente.

Conclusión CCTV se presenta infrecuentemente en la población pediátrica, Anomalías genéticas y epigeneticas han sido propuestas como causas predisponentes al igual que la exposición a carcinogénicos. Los casos reportados tienden a tener un buen pronostico y la gran mayoría son no musculo invasivos al momento del diagnostico. Protocolos de seguimiento no están claramente definidos igual que vías moleculares en la tumorogenésis y marcadores pronósticos.

 
  • References

  • 1 Javadpour N, Mostofi FK. Primary epithelial tumors of the bladder in the first two decades of life. J Urol 1969; 101 (05) 706-710
  • 2 Lerena J, Krauel L, García-Aparicio L, Vallasciani S, Suñol M, Rodó J. Transitional cell carcinoma of the bladder in children and adolescents: six-case series and review of the literature. J Pediatr Urol 2010; 6 (05) 481-485
  • 3 Alanee S, Shukla AR. Bladder malignancies in children aged <18 years: results from the Surveillance, Epidemiology and End Results database. BJU Int 2010; 106 (04) 557-560
  • 4 Rifat UN, Hamadalla NY, Chiad Safi KC, Al Habash SS, Mohammed M, Hospital J. Urothelial bladder tumour in childhood: A report of two cases and a review. Arab J Urol 2015; 13 (02) 116-121 . Doi: 10.1016/j.aju.2014.11.002 [Internet]
  • 5 Kim SC, Park S, Song SH, Kim KS, Park S. Clinicopathological Characteristics of Urinary Bladder Tumors in Korean Patients 20 Years or Younger. J Korean Med Sci 2018; 33 (40) e242
  • 6 Dowling CR, Reddihough D, Smith P, Webb N, McNeill R, Clouston D. Transitional cell carcinoma in the paediatric population: be aware of unusual aetiologies. J Paediatr Child Health 2007; 43 (11) 773-775
  • 7 Humphrey PA, Moch H, Cubilla AL, Ulbright TM, Reuter VE. The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part B: Prostate and Bladder Tumours. Eur Urol 2016; 70 (01) 106-119 . Doi: 10.1016/j.eururo.2016.02.028 [Internet]
  • 8 Wang L, Fu D, Qiu Y. , et al. Genome-wide screening and identification of long noncoding RNAs and their interaction with protein coding RNAs in bladder urothelial cell carcinoma. Cancer Lett 2014; 349 (01) 77-86 . Doi: 10.1016/j.canlet.2014.03.033 [Internet]
  • 9 Uçar M, Demirkaya M, Aytaç Vuruşkan B, Balkan E, Kılıç N, Kılıç N. Urothelial Carcinoma of the Bladder in Pediatric Patient: Four Case Series and Review of the Literature. Balkan Med J 2018; 35 (03) 268-271
  • 10 Bujons A, Caffaratti J, Garat JM, Villavicencio H. Long-term follow-up of transitional cell carcinoma of the bladder in childhood. J Pediatr Urol 2014; 10 (01) 167-170
  • 11 Pérez Niño J, Malo Rodríguez G, Llinás Lemus E. Comportamiento de las neoplasias uroteliales de vejiga en adolescentes. Urol Colomb. 2009; 18 (02) 7
  • 12 Saltsman JA, Malek MM, Reuter VE, Hammond WJ, Danzer E, Herr HW, LaQuaglia MP. Urothelial neoplasms in pediatric and young adult patients: A large single-center series. J Pediatr Surg 2018; 53 (02) 306-309
  • 13 Stanton ML, Xiao L, Czerniak BA, Guo CC. Urothelial tumors of the urinary bladder in young patients: a clinicopathologic study of 59 cases. Arch Pathol Lab Med 2013; 137 (10) 1337-1341
  • 14 Castillo-martin M, Collazo A, Gladoun N. H-RAS mutation is a key molecular feature of pediatric urothelial bladder cancer. A detailed report of three cases. J Pediatr Urol 2015; (March): 1-7 . Doi: 10.1016/j.jpurol.2015.08.020 [Internet]
  • 15 Williamson SR, Wang M, Montironi R. , et al. Molecular characteristics of urothelial neoplasms in children and young adults: a subset of tumors from young patients harbors chromosomal abnormalities but not FGFR3 or TP53 gene mutations. Mod Pathol 2014; 27 (11) 1540-1548 . Doi: 10.1038/modpathol.2014.48
  • 16 Wild PJ, Giedl J, Stoehr R. , et al. Genomic aberrations are rare in urothelial neoplasms of patients 19 years or younger. J Pathol 2007; 211 (01) 18-25
  • 17 Mongiat-Artus P, Miquel C, Van Der Aa M. Infrequent Microsatellite Instability in Urothelial Cell Carcinoma of the Bladder in Young Patients. Eur Urol 2006; 49: 685-690
  • 18 Christensen M, Jensen MA, Wolf H, Orntoft TF. Pronounced microsatellite instability in transitional cell carcinomas from young patients with bladder cancer. Int J Cancer 1998; 79 (04) 396-401
  • 19 Owen HC, Giedl J, Wild PJ. , et al. Low frequency of epigenetic events in urothelial tumors in young patients. J Urol 2010; 184 (02) 459-463 . Doi: 10.1016/j.juro.2010.03.131