title: High-grade urothelial bladder cancer in children: A case report and critical analysis of the literature.
abstract: BACKGROUND
  Bladder cancer is relatively common in adults. In children, it is extremely rare and in the majority of cases, low grade, low stage urothelial cancers are found.
  
  
  METHODS
  We describe the diagnostic, therapeutic, and follow-up management of bladder cancer in a 3-year-old boy examined for painless hematuria. Transurethral resection of the tumor was performed and T1 high grade urothelial cancer with osseous metaplasia was found in definitive specimens. During the 2-year follow-up, there has been no recurrence. Typical characteristics of the most prevalent bladder tumors are presented.
  
  
  CONCLUSIONS
  Despite its low incidence and low prevalence bladder cancer in children is a very serious condition which must not be missed in the differential diagnosis of hematuria or urinary tract infection. It is vital to differentiate urothelial cancer from hamartoma and nephrogenic adenoma and, particularly in osseous metaplasia, from sarcomatoid carcinoma. Especially in high-grade cancers, precise TUR of the tumor with a careful follow-up is essential to detect cancer recurrence and reduce progression.
authors.affiliation: Department of Urology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
authors.forename: Milan
authors.initials: M
authors.lastname: Kral
authors.affiliation: Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Michalek
authors.affiliation: Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
authors.forename: Jozef
authors.initials: J
authors.lastname: Skarda
authors.affiliation: Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Tichy
authors.affiliation: Department of Urology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
authors.forename: Oldrich
authors.initials: O
authors.lastname: Smakal
authors.affiliation: Department of Pathology and Molecular Medicine, Faculty Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Czech Republic.
authors.forename: Roman
authors.initials: R
authors.lastname: Kodet
authors.affiliation: Department of Urology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Student
mesh_terms: D000359:Aftercare; D002675:Child, Preschool; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D014463:Ultrasonography; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000601:surgery*
keywords: bladder cancer; children; pathology; treatment