Pediatric papillary urothelial neoplasm: 18-year single-center experience in diagnosis and treatment

Abstract Objective This study outlines the diagnosis, treatment, and follow-up protocols for pediatric bladder urothelial tumors, sharing insights from clinical experience to assist pediatric surgeons. Method A retrospective analysis was conducted on medical records from January 2006 to January 2024...

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Main Authors: Pei Liu, Xin Li, Jiayi Li, Zonghan Li, Yang Yang, Ning Sun, Hongcheng Song, Weiping Zhang
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Urology
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Online Access:https://doi.org/10.1186/s12894-025-01831-6
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author Pei Liu
Xin Li
Jiayi Li
Zonghan Li
Yang Yang
Ning Sun
Hongcheng Song
Weiping Zhang
author_facet Pei Liu
Xin Li
Jiayi Li
Zonghan Li
Yang Yang
Ning Sun
Hongcheng Song
Weiping Zhang
author_sort Pei Liu
collection DOAJ
description Abstract Objective This study outlines the diagnosis, treatment, and follow-up protocols for pediatric bladder urothelial tumors, sharing insights from clinical experience to assist pediatric surgeons. Method A retrospective analysis was conducted on medical records from January 2006 to January 2024, involving 17 pediatric cases treated at our hospital. The patients were categorized into two groups: Group 1 included children diagnosed with the pathological type “urothelial papilloma” (UP), while Group 2 consisted of those with the pathological type “papillary urothelial neoplasm of low malignant potential” (PUNLMP). The primary outcomes of the study were the presence or absence of recurrence. Results The average age of the patients was 10.5 years, with all patients being male. Gross hematuria was the predominant symptom, observed in 88.2% of cases. All patients underwent a urinary ultrasound examination. Open resection of bladder tumors was performed in 82.3% of patients, while the remainder underwent transurethral resection of bladder tumors (TURBT) surgery. Pathologic findings revealed UP in 11 cases and PUNLMP in 6 cases. The median follow-up duration was 46 months. Two out of the six PUNLMP patients received postoperative chemotherapy with bladder instillation, while the remaining 4 patients did not receive this treatment. Among those not treated, one patient experienced a recurrence 25 months after the initia surgery. Subsequently, the patient underwent a second bladder tumor resection and received intravesical chemotherapy. No recurrences were noted following bladder instillation chemotherapy. Conclusion Children presenting with gross hematuria should be evaluated for bladder urothelial tumors. Timely ultrasonography aids in diagnosis. The prognosis for children with this condition is favorable, although recurrence is possible. Ultrasound monitoring is crucial during follow-up, and prophylactic bladder instillation chemotherapy may be considered for children with PUNLMP to reduce recurrence risk, though further evidence is required to validate this approach. Levels of evidence Level III.
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spelling doaj-art-9ab2cc25e939455abfa1c46b4d7f451e2025-08-20T04:02:44ZengBMCBMC Urology1471-24902025-06-012511810.1186/s12894-025-01831-6Pediatric papillary urothelial neoplasm: 18-year single-center experience in diagnosis and treatmentPei Liu0Xin Li1Jiayi Li2Zonghan Li3Yang Yang4Ning Sun5Hongcheng Song6Weiping Zhang7Department of Urology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Urology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Urology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Urology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Urology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Urology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Urology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Urology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthAbstract Objective This study outlines the diagnosis, treatment, and follow-up protocols for pediatric bladder urothelial tumors, sharing insights from clinical experience to assist pediatric surgeons. Method A retrospective analysis was conducted on medical records from January 2006 to January 2024, involving 17 pediatric cases treated at our hospital. The patients were categorized into two groups: Group 1 included children diagnosed with the pathological type “urothelial papilloma” (UP), while Group 2 consisted of those with the pathological type “papillary urothelial neoplasm of low malignant potential” (PUNLMP). The primary outcomes of the study were the presence or absence of recurrence. Results The average age of the patients was 10.5 years, with all patients being male. Gross hematuria was the predominant symptom, observed in 88.2% of cases. All patients underwent a urinary ultrasound examination. Open resection of bladder tumors was performed in 82.3% of patients, while the remainder underwent transurethral resection of bladder tumors (TURBT) surgery. Pathologic findings revealed UP in 11 cases and PUNLMP in 6 cases. The median follow-up duration was 46 months. Two out of the six PUNLMP patients received postoperative chemotherapy with bladder instillation, while the remaining 4 patients did not receive this treatment. Among those not treated, one patient experienced a recurrence 25 months after the initia surgery. Subsequently, the patient underwent a second bladder tumor resection and received intravesical chemotherapy. No recurrences were noted following bladder instillation chemotherapy. Conclusion Children presenting with gross hematuria should be evaluated for bladder urothelial tumors. Timely ultrasonography aids in diagnosis. The prognosis for children with this condition is favorable, although recurrence is possible. Ultrasound monitoring is crucial during follow-up, and prophylactic bladder instillation chemotherapy may be considered for children with PUNLMP to reduce recurrence risk, though further evidence is required to validate this approach. Levels of evidence Level III.https://doi.org/10.1186/s12894-025-01831-6Pediatric urothelial carcinomaBladder neoplasmsIntravesical chemotherapyPapillary urothelial neoplasm of low malignant potentialPediatrics
spellingShingle Pei Liu
Xin Li
Jiayi Li
Zonghan Li
Yang Yang
Ning Sun
Hongcheng Song
Weiping Zhang
Pediatric papillary urothelial neoplasm: 18-year single-center experience in diagnosis and treatment
BMC Urology
Pediatric urothelial carcinoma
Bladder neoplasms
Intravesical chemotherapy
Papillary urothelial neoplasm of low malignant potential
Pediatrics
title Pediatric papillary urothelial neoplasm: 18-year single-center experience in diagnosis and treatment
title_full Pediatric papillary urothelial neoplasm: 18-year single-center experience in diagnosis and treatment
title_fullStr Pediatric papillary urothelial neoplasm: 18-year single-center experience in diagnosis and treatment
title_full_unstemmed Pediatric papillary urothelial neoplasm: 18-year single-center experience in diagnosis and treatment
title_short Pediatric papillary urothelial neoplasm: 18-year single-center experience in diagnosis and treatment
title_sort pediatric papillary urothelial neoplasm 18 year single center experience in diagnosis and treatment
topic Pediatric urothelial carcinoma
Bladder neoplasms
Intravesical chemotherapy
Papillary urothelial neoplasm of low malignant potential
Pediatrics
url https://doi.org/10.1186/s12894-025-01831-6
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