EC Paediatrics

Introduction: Pediatric bladder tumors are rare and biologically distinct from their adult counterparts, exhibiting notable differences in histology, clinical behavior, and prognosis. Due to their low incidence and heterogeneity, standardized diagnostic and surveillance protocols for children are lacking. This study aims to present a decade-long, single-center experience, providing key insights into the diagnosis, treatment, and follow-up of pediatric bladder tumors, with the goal of contributing to the development of pediatric-specific management strategies.

Observations: Between 2013 and 2023, seven pediatric patients (ages 3 - 15 years) were diagnosed with bladder tumors at our institution. Histopathological diagnoses included papillary urothelial neoplasms of low malignant potential, low-grade urothelial carcinoma, papilloma, fibroepithelial polyp, inflammatory myofibroblastic tumor, hemangioma, and rhabdomyosarcoma. Clinical presentations ranged from incidental imaging findings to gross hematuria and urinary retention. Management strategies were individualized based on tumor type, location, and severity, including transurethral resection, laser ablation, partial cystectomy, or multimodal oncologic therapy. No recurrences were observed during a median follow-up of 3.5 years. Diagnostic imaging, cystoscopy, and histopathological evaluation were essential for accurate diagnosis, and treatment prioritized bladder preservation when feasible.

Conclusion and Relevance: Pediatric bladder tumors typically follow an indolent course and respond well to conservative surgical approaches, with excellent long-term outcomes. This experience underscores the need for pediatric-specific diagnostic pathways and follow-up protocols that minimize unnecessary invasiveness while ensuring oncological safety. The adoption of histology-adapted surveillance strategies could significantly enhance patient care by preventing overtreatment of low-risk lesions and ensuring vigilant monitoring of high-risk tumors.

 Keywords: Pediatric Bladder Tumors; Papillary Urothelial Neoplasms of Low Malignant Potential (PUNLMP); Rhabdomyosarcomas (RMS)

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