# 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.

## Key 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.