Low grade T1 non-muscle invasive urothelial carcinoma in pediatric patient: A rare case report and management dilemma

TL;DR

A 10-year-old girl with a rare low-grade bladder tumor highlights the challenges of diagnosing and treating urothelial carcinoma in children.

Contribution

This case report presents a rare pediatric instance of low-grade urothelial carcinoma and discusses its management challenges.

Findings

The tumor was a 1 cm exophytic lesion confirmed by cystoscopy and histopathology.

Complete resection led to an uneventful recovery with no recurrence observed.

Adjuvant BCG therapy was avoided due to low progression risk and potential side effects.

Abstract

Papillary urothelial carcinoma (UC) is rare in the pediatric population, with its presentation and etiology differing significantly from adults, posing unique diagnostic challenges. This case report describes a 10-year-old female with abdominal pain and microscopic hematuria. Ultrasonography identified a hypoechoic lesion, and subsequent cystoscopy confirmed a 1 cm exophytic tumor. Histopathology revealed a papillary UC with focal lamina propria invasion. The postoperative course was uneventful with no evidence of recurrence. Pediatric low-grade UC is a distinct entity with an excellent prognosis following complete resection. This case underscores the need to consider malignancy in the differential diagnosis of pediatric hematuria.

•Diagnostic Challenge: Microscopic hematuria in a child requires complete urological evaluation to exclude rare malignancies.•Therapeutic Conservatism: Adjuvant BCG was omitted due to the tumor's low progression risk and therapy's side effects.•Vigilant Surveillance: A cautious approach was prioritized to enable early detection of recurrence and preserve excellent prognosis.

Diagnostic Challenge: Microscopic hematuria in a child requires complete urological evaluation to exclude rare malignancies.

Therapeutic Conservatism: Adjuvant BCG was omitted due to the tumor's low progression risk and therapy's side effects.

Vigilant Surveillance: A cautious approach was prioritized to enable early detection of recurrence and preserve excellent prognosis.

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