Prognostic markers in low-grade papillary urothelial neoplasms of the urinary bladder: an update

Context.—Urothelial tumors are rare in young patients. Because of their rarity, the natural history of the disease in young patients remains poorly understood. Objective.—To understand the pathologic and clinical features of urothelial tumors of the urinary bladder in young patients. Design.—We identified 59 young patients with urothelial tumors of the urinary bladder treated at our institution and analyzed the tumors' pathologic features and the patients' clinical outcomes. Results.—All patients were 30 years or younger, with a mean age of 23.5 years (range, 4–30). Thirty-eight patients (64%) were male, and 21 (36%) were female. Most tumors were noninvasive, papillary urothelial tumors (49 of 59; 83%), including papillary urothelial neoplasms of low malignant potential (7 of 49; 14%), low-grade papillary urothelial carcinomas (38 of 49; 78%), and high-grade papillary urothelial carcinomas (4 of 49; 8%). Only a few (n = 10) of the urothelial tumors were invasive, invading the lamina propria (n = 5; 50%), muscularis propria (n = 4; 40%), or perivesical soft tissue (n = 1; 10%). Clinical follow-up information was available for 41 patients (69%), with a mean follow-up time of 77 months. Of 31 patients with noninvasive papillary urothelial tumors, only 1 patient (3%) later developed an invasive urothelial carcinoma and died of the disease, and 30 of these patients (97%) were alive at the end of follow-up, although 10 (32%) had local tumor recurrences. In the 10 patients with invasive urothelial carcinomas, 3 patients (30%) died of the disease and 5 others (50%) were alive with metastases (the other 2 [20%] were alive with no recurrence). Conclusion.—Urothelial tumors in young patients are mostly noninvasive, papillary carcinomas and have an excellent prognosis; however, a small subset of patients may present with high-grade invasive urothelial carcinomas that result in poor clinical outcomes.

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Polyps and Masses of the Pediatric Urinary Bladder: A 21-Year Pathology Review

Pediatric and Developmental Pathology ◽

10.2350/11-01-0958-oa.1 ◽

2011 ◽

Vol 14 (6) ◽

pp. 438-444 ◽

Cited By ~ 22

Author(s):

Alison R. Huppmann ◽

Bruce R. Pawel

Keyword(s):

Urinary Bladder ◽

Pediatric Population ◽

Low Grade ◽

Nephrogenic Adenoma ◽

Patient Demographics ◽

Urothelial Tumors ◽

Histologic Types ◽

Cystitis Cystica ◽

Pathology Review ◽

Made In

Although not uncommon in adults, bladder tumors are rare in children. In addition, the histologic types of tumors seen in the pediatric population differ from those seen in adults. Although rhabdomyosarcoma is the most common pediatric bladder tumor, many other benign, malignant, and reactive lesions can be encountered. All may present clinically as a mass or polyp in the bladder. This study was designed to describe the pathology and patient demographics of pediatric bladder masses, because there are few studies describing these entities. Retrospectively reviewing our experience over a 21-year period, we identified 98 specimens from 65 patients with polyps or masses in the urinary bladder. As expected, the most frequent diagnosis was rhabdomyosarcoma. This was followed by fibroepithelial polyp and a variety of additional nonurothelial tumors. Only 7 urothelial tumors were identified, including 1 low-grade papillary urothelial carcinoma. Inflammatory lesions, such as cystitis cystica and nephrogenic adenoma, were invariably associated with an irritating factor when a history was provided. Our findings emphasize that diagnoses made in the pediatric urinary bladder are distinct from those in adults, although a wide variety of lesions may still be seen.

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Spectrum of histomorphological diagnosis in cystoscopic bladder biopsies

Journal of Pathology of Nepal ◽

10.3126/jpn.v7i1.16913 ◽

2017 ◽

Vol 7 (1) ◽

pp. 1062-1065

Author(s):

R Thapa ◽

M Lakhey ◽

AD Bhatta

Keyword(s):

Urinary Bladder ◽

Urothelial Carcinoma ◽

Clinical Symptoms ◽

Transitional Cell ◽

Research Centre ◽

Low Grade ◽

Bladder Tumors ◽

Primary Tumors ◽

Neoplastic Lesions ◽

Papillary Urothelial Carcinoma

Background: Urinary bladder lesions are the main source of significant clinical symptoms which are more disabling than lethal. Bladder tumors constitute one of the most common urological pathology. Urothelial carcinoma accounts for 90% of all primary tumors of the bladder. This study aimed to determine the frequency of different types of lesions of the urinary bladder and to determine the grade and stage of urothelial tumors.Materials and Methods: This is a 2 years cross sectional study of cystoscopic biopsies carried out in the Department of Pathology, Medicare National Hospital and Research Centre, Kathmandu, Nepal.Results: Out of 87 cases, 58 (66.67%) cases were neoplastic lesions and 29(33.33%) cases were non- neoplastic lesions. Majority of neoplastic lesions 96.55% were urothelial (transitional cell) tumors comprising predominantly of low grade papillary urothelial carcinoma 50.91%. Muscle invasion was seen only in high grade papillary urothelial carcinomas.Conclusion: Among bladder tumors low grade papillary urothelial carcinoma is the most common.

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Overexpression of DJ-1 and HSP90α, and loss of PTEN associated with invasive urothelial carcinoma of urinary bladder: Possible prognostic markers

Oncology Letters ◽

10.3892/ol.2011.522 ◽

2011 ◽

Cited By ~ 1

Author(s):

Jae Ro

Keyword(s):

Urinary Bladder ◽

Urothelial Carcinoma ◽

Prognostic Markers

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Cytokeratin expression patterns in low-grade papillary urothelial neoplasms of the urinary bladder

Cancer ◽

10.1002/cncr.11265 ◽

2003 ◽

Vol 97 (8) ◽

pp. 1876-1883 ◽

Cited By ~ 40

Author(s):

David Ramos ◽

Samuel Navarro ◽

Rafael Villamón ◽

Manuel Gil-Salom ◽

Antonio Llombart-Bosch

Keyword(s):

Urinary Bladder ◽

Expression Patterns ◽

Low Grade ◽

Cytokeratin Expression

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Expression of FGFR3 Protein and Gene Amplification in Urinary Bladder Lesions in Relation to Schistosomiasis

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2017.048 ◽

2017 ◽

Vol 5 (2) ◽

pp. 160-166 ◽

Cited By ~ 1

Author(s):

Olfat Hammam ◽

Tarek Aboushousha ◽

Ali El-Hindawi ◽

Hosni Khairy ◽

Heba Khalil ◽

...

Keyword(s):

Bladder Cancer ◽

Urinary Bladder ◽

Gene Amplification ◽

Target Therapy ◽

Low Grade ◽

Tumour Grade ◽

Fgfr3 Gene ◽

Incidence And Mortality ◽

Fourth Decade ◽

Urothelial Bladder

BACKGROUND: Bladder cancer represents the fifth most common malignancy worldwide and a major cause of cancer-related morbidity and death. Incidence and mortality rates have remained relatively constant over the past four decades. Urothelial bladder cancers have identified multiple risk factors.AIM: We aimed at evaluating the expression of the FGFR3 protein and gene amplification in the urothelial cells of neoplastic and non-neoplastic urothelial lesions of the urinary bladder, and correlation with tumour grade, stage and associated bilharziasis.MATERIAL AND METHODS: One hundred and five different urinary bladder lesions were studied, including 15 cystitis cases (9 bilharzial and 6 non-bilharzial cystitides), 75 urothelial carcinoma cases (18 bilharzial associated and 57 non-bilharzial associated) and 15 squamous cell carcinoma associated with bilharziasis, beside 5 control cases. Data concerning age, sex, tumour grade, stage, and associated bilharziasis were obtained. Each case was studied for FGFR3 expression, and FISH technique was applied on forty malignant cases that show high protein expression.RESULTS: The highest incidence of cystitis was in the fourth decade while of bladder cancer was in the seventh decade. Tumour grade was correlated significantly with tumour stage. FGFR3 correlates significantly with tumour grade, stage and with a bilharzial infestation. FGFR3 gene amplification was reported mainly in low grade and NNMBIC tumours.CONCLUSIONS: FGFR3 overexpression in malignant cases was significantly higher than in chronic cystitis. FGFR3 gene amplification was reported mainly in low grade and NNMBIC tumours. FGFR3 may be further studied as a subject for target therapy of bladder cancer.

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