title: Transitional cell carcinoma of the bladder in children and adolescents: six-case series and review of the literature.
abstract: OBJECTIVE
  Lower urinary tract tumours are uncommon in paediatrics. Transitional cell carcinoma of the bladder (TCCB) is rarely found in the first two decades of life and is exceptional under 10 years of age. The present series aimed to expand the number of reported cases in the literature.
  
  
  METHODS
  In 1984-2007, six patients (four male, two female), aged 6, 9, 12, 13, 14 and 17 years, were treated at our centre. Clinical presentation was macroscopic haematuria in five and pyelonephritis in one. Physical examination, laboratory analysis, ultrasound and cystoscopy were performed before surgical treatment in all patients. Follow up was by clinical and ultrasound assessment.
  
  
  RESULTS
  Neither physical examination nor laboratory analysis revealed any significant abnormalities, but ultrasound showed exophytic intravesical lesions. Surgical resection was performed endoscopically. Histological studies showed grade I TCCB in all cases. The immediate postoperative period was uneventful and long-term follow up did not reveal recurrence.
  
  
  CONCLUSIONS
  Despite its low incidence in children, TCCB must be suspected in the event of macroscopic haematuria. Ultrasound followed by cystoscopy are the ideal diagnostic tools for visualization of these tumours. Endoscopic resection proved effective in all the present cases. Follow up must be clinical with periodic ultrasound evaluation. Urine cytologic examination is ineffective. Periodic cystoscopy is indicated only in cases of clinical or ultrasonographic suspicion of recurrence.
authors.affiliation: Urology Unit, Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Lerena
authors.forename: Lucas
authors.initials: L
authors.lastname: Krauel
authors.forename: Luis
authors.initials: L
authors.lastname: García-Aparicio
authors.forename: Santiago
authors.initials: S
authors.lastname: Vallasciani
authors.forename: Mariona
authors.initials: M
authors.lastname: Suñol
authors.forename: Joan
authors.initials: J
authors.lastname: Rodó
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D002648:Child; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008297:Male; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*