Transitional Cell Carcinoma of the Bladder in Children Long Term Follow-Up

Summary: The aim of our study is to report on long term follow-up on TCCB in children. Materials and Methods: From 1990 to 2014, 5 patients, female, age range 12-15 years (mean 13.2 years), were referred to our center with TCCB. In 4 patients the clinical symptoms debut was a 'gross hematuria. Of these, 1 patient had been operated on two years before, for UPJ obstruction with double-J stent apposition. The endoscopy performed during this operation as a diagnostic routine did not show any abnormality of the bladder wall. In 1 patient the tumor was an incidental finding during cystoscopy for endoscopic correction of vesicoureteral reflux. All patients underwent successful transurethral resection by pediatric resectoscope. Results: At a mean follow-up of 15 years no recurrence was registered. All patients underwent to the following follow-up: endoscopy, renal and bladder ultrasound and urinary cytology every 6 months the first year. US and urinary cytology every 6 months the first two year then yearly and out of protocol after 5 years free of disease. The oldest patients of this series were recently contacted by telephone interview to prepare the present review by asking them to perform a reno-vesical ultrasound which was negative in all patients. Conclusion: The low incidence of TCC shows the rarity of this finding in the pediatric population and an unexpected exclusive prerogative of the female sex, in our experience. The main clinical manifestation of such injuries is haematuria; commonly these are solitary lesions, low-grade histology and low risk of progression. Our case studies, probably one of the longest follow-up in the literature, confirm that in this age group the prognosis also in the long term is particularly favorable.