# Transurethral thulium laser resection via ureterorenoscope for pediatric low-grade urothelial carcinoma of the bladder: a case report

## TL;DR

A 9-year-old boy with bladder cancer was successfully treated using a specialized laser surgery adapted for children's anatomy.

## Contribution

This case report introduces transurethral thulium laser resection via ureterorenoscope as a feasible technique for pediatric bladder cancer.

## Key findings

- Transurethral thulium laser resection via ureterorenoscope was successfully used in a pediatric patient.
- Histopathology confirmed low-grade papillary urothelial carcinoma with no recurrence after one year.
- The procedure was safe and effective for pediatric anatomy, avoiding adult-sized instruments.

## Abstract

To report a case of pediatric bladder urothelial carcinoma treated with transurethral thulium laser resection and, based on a literature review, to discuss its clinical characteristics, diagnostic considerations, and surgical strategies adapted to the unique anatomy of the pediatric urethra.

The clinical data of a child with bladder urothelial carcinoma admitted to the Second Department of Urology, The First Affiliated Hospital of Kunming Medical University in October 2024 were retrospectively analyzed.

A 9-year-old boy presented with transient, painless gross hematuria as the primary clinical manifestation. Bladder tumor was diagnosed via imaging. He subsequently underwent transurethral thulium laser resection of the bladder tumor via ureteroscopy under general anesthesia. The procedure was successful, and immediate postoperative intravesical chemotherapy was administered. Histopathological examination confirmed low-grade papillary urothelial carcinoma of the bladder. The patient has since received regular postoperative intravesical chemotherapy. Follow-up at one year showed no evidence of tumor recurrence on ultrasound.

Bladder urothelial carcinoma is exceedingly rare in children. Raising awareness and vigilance among healthcare providers and families is essential for early diagnosis. In cases where standard adult instruments are unsuitable, transurethral thulium laser resection via a ureterorenoscope represents a safe and feasible adaptive technique for pediatric low-grade non-muscle-invasive urothelial carcinoma. This report offers a practical reference for the management of such rare cases.