title: Urothelial neoplasm of the bladder in childhood and adolescence: a rare disease.
abstract: OBJECTIVE
  Bladder tumors are rare in children and adolescents. For this reason, the diagnosis is sometimes delayed in pediatric patients. We aimed to describe the diagnosis, treatment, and follow-up methods of bladder urothelial neoplasms in children and adolescents.
  
  
  METHODS
  We carried out a retrospective multicenter study involving patients who were treated between 2008 and 2014. Eleven patients aged younger than 18 years were enrolled in the study. In all the patients, a bladder tumor was diagnosed using ultrasonography and was treated through transurethral resection of the bladder (TURBT).
  
  
  RESULTS
  Nine of the 11 patients (82%) were admitted with gross hematuria. The average delay in diagnosis was 3 months (range, 0-16 months) until the ultrasonographic diagnosis was performed from the first episodes of macroscopic hematuria. A single exophytic tumor (1-4cm) was present in each patient. The pathology of all patients was reported as superficial urothelial neoplasm: two with papilloma, one with papillary urothelial neoplasm of low malignant potential (PUNLMP), four with low grade pTa, and four with low grade pT1. No recurrence was observed during regular cystoscopic and ultrasonographic follow-up.
  
  
  CONCLUSIONS
  Regardless of the presence of hematuria, bladder tumors in children are usually not considered because urothelial carcinoma in this population is extremely rare, which causes a delay in diagnosis. Fortunately, the disease has a good prognosis and recurrences are infrequent. Cystoscopy may be unnecessary in the follow-up of children with bladder tumors. We believe that ultrasonography is sufficient in follow-up.
authors.affiliation: Adiyaman University, Faculty of Medicine, Department of Urology, Adiyaman, Turkey.
authors.forename: Haci
authors.initials: H
authors.lastname: Polat
authors.affiliation: Dicle University, Faculty of Medicine, Department of Urology, Diyarbakir, Turkey.
authors.forename: Mehmet M
authors.initials: MM
authors.lastname: Utangac
authors.affiliation: Canakkale Onsekiz Mart University, Faculty of Medicine, Department of Urology, Canakkale, Turkey.
authors.forename: Murat T
authors.initials: MT
authors.lastname: Gulpinar
authors.affiliation: Adiyaman University, Faculty of Medicine, Department of Urology, Adiyaman, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Cift
authors.affiliation: Adiyaman University, Faculty of Medicine, Department of Medical Pathology, Adiyaman, Turkey.
authors.forename: Ibrahim Halil
authors.initials: IH
authors.lastname: Erdogdu
authors.affiliation: Dicle University, Faculty of Medicine, Department of Medical Pathology, Diyarbakir, Turkey.
authors.forename: Gul
authors.initials: G
authors.lastname: Turkcu
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000601:surgery*; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D002648:Child; D003558:Cystoscopy / Q000379:methods; D057210:Delayed Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006417:Hematuria; D006801:Humans; D008297:Male; D035583:Rare Diseases; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D019459:Urothelium / Q000473:pathology