Urothelial carcinoma in a child with gross hematuria: a complaint not to be dismissed

2021 ◽  
Vol 14 (12) ◽  
pp. e247239
Author(s):  
Han Lim Ong ◽  
Han Jie Lee ◽  
Tze Kiat Ng ◽  
Te-Lu Yap
Keyword(s):  
Urothelial Carcinoma ◽  
Significant Morbidity ◽  
Gross Hematuria ◽  
Underlying Pathology

Hematuria is not uncommonly seen among children. We describe the case of a 13-year-old boy who was diagnosed with urothelial carcinoma after presenting with persistent gross hematuria for 2 weeks. We highlight the importance of adequate workup for gross hematuria as it is often associated with an underlying pathology that could lead to significant morbidity if left undiagnosed.

scholarly journals Urothelial Carcinoma in a 22-Year-Old Female with Angelman Syndrome

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Jessica Pugh ◽  
R. Keith Huffaker
Keyword(s):  
Abdominal Pain ◽  
Urothelial Carcinoma ◽  
Angelman Syndrome ◽  
White Female ◽  
Genetic Mutations ◽  
Low Grade ◽  
Gross Hematuria ◽  
Delay In Diagnosis ◽  
History Of

A 22-year-old nulligravid white female with Angelman syndrome was noted to have a 4-month history of premenstrual nausea, vomiting, and abdominal pain. She had an echogenic focus in her bladder noted on ultrasound. She was diagnosed with low grade urothelial carcinoma after cystoscopic evaluation with biopsy and was sent to urology for further treatment. Urothelial carcinoma is rare in individuals younger than age 40. Patients may present with gross hematuria. There is often a delay in diagnosis in younger individuals with different genetic mutations noted upon diagnosis.

scholarly journals Metastatic Transitional Cell Carcinoma of the Bladder to the Testis: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Gregory N. Kozak ◽  
Nicholas C. Field
Keyword(s):  
Urothelial Carcinoma ◽  
Lymphovascular Invasion ◽  
Transitional Cell ◽  
Bladder Neck Contracture ◽  
Gross Hematuria ◽  
Metastatic Urothelial Carcinoma ◽  
Poorly Differentiated ◽  
Papillary Urothelial Carcinoma ◽  
Carcinoma Of The Bladder

An 84-year-old gentleman presented with onset of gross hematuria in September 2010. Follow-up investigations revealed T1 superficially invasive, poorly differentiated, papillary urothelial carcinoma. He subsequently had GreenLight laser for BPH and bladder neck contracture on two occasions. He developed a right hydrocele 16 months after initial presentation and during his hydrocelectomy, a rock-hard right epididymis and testicle were discovered. Pathology revealed metastatic urothelial carcinoma replacing nearly the entire testis with lymphovascular invasion.

scholarly journals A Case of Early Stage Bladder Carcinosarcoma in Late Recurrence of Urothelial Carcinoma after Transurethral Resection

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Daisaku Hirano ◽  
Toshiyuki Yoshida ◽  
Daigo Funakoshi ◽  
Fuminori Sakurai ◽  
Shou Ohno ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Transurethral Resection ◽  
Early Stage ◽  
Bladder Wall ◽  
Late Recurrence ◽  
Gross Hematuria ◽  
Pelvic Mri ◽  
History Of ◽  
The Right ◽  
Immunohistochemical Studies

Carcinosarcomas of the urinary bladder are rare biphasic neoplasms, consisting of both malignant epithelial and malignant mesenchymal components, and the prognosis of this tumor is unfavorable in most patients with even possibility of resection of disease. A 77-year-old male with a history of transurethral resection (TUR) of urothelial carcinoma (UC) of the bladder and adjuvant intravesical chemotherapy with pirarubicin 10 years ago revisited our department with a gross hematuria. Cystoscopy demonstrated an approximately 2.5 cm nonpapillary tumor on the right wall of the bladder. Pelvic MRI showed the tumor without extending the base of the bladder wall. The tumor could be completely removed with TUR. The malignant epithelial elements consisted of high-grade UC and the majority of mesenchymal components were fibrosarcomatous differentiation based on immunohistochemical studies. The tumor could be pathologically also suspected to be an early stage on TUR specimens. Although he has received no additional intervention due to the occurrence of myocardial infarction at three weeks after the TUR, he has been alive with no evidence of recurrence of the disease 27 months after the TUR. Some early stages of bladder carcinosarcoma might have a favorable prognosis without aggressive treatments.

scholarly journals Lipid Cell and Micropapillary Variants of Urothelial Carcinoma of the Ureter

2015 ◽  
Vol 8 (3) ◽  
pp. 515-519 ◽  
Author(s):  
Yu Miyama ◽  
Teppei Morikawa ◽  
Tohru Nakagawa ◽  
Yukio Homma ◽  
Masashi Fukayama
Keyword(s):  
Urothelial Carcinoma ◽  
Growth Factor Receptor ◽  
Immunohistochemical Analysis ◽  
Urinary Cytology ◽  
Urothelial Cells ◽  
Gross Hematuria ◽  
Retrograde Pyelography ◽  
Initial Surgery ◽  
Epidermal Growth ◽  
Cell Variant

We report on a case of urothelial carcinoma (UC) with lipid cell and micropapillary variants in the ureter. A 64-year-old man presented with gross hematuria. Urinary cytology revealed the presence of atypical urothelial cells. Computed tomography and drip infusion/retrograde pyelography identified a mass-occupying lesion in the left mid-ureter, as well as left hydronephrosis. A clinical diagnosis of left ureteral cancer was given and the patient underwent left nephroureterectomy. Microscopically, the major component of the tumor was a conventional high-grade UC. In the invasive region, however, lipid cell and micropapillary variants of UC were also observed. Upon immunohistochemical analysis, all of the components were diffusely positive for cytokeratin 7 and p53. Intense membranous expression of human epidermal growth factor receptor 2 (HER2) was also observed in both the lipid cell and micropapillary variants of UC, whereas weak and incomplete staining was observed in most regions of the conventional UC. The pathological stage was pT3 N2. Multiple times, the patient experienced recurrence of the UC in the urinary bladder and urethra. Although the patient underwent total cystectomy and urethrectomy, 52 months following the initial surgery, signs of local recurrence developed, as well as multiple lymph node and bone metastases. The patient died 75 months following the initial surgery. To the best of our knowledge, this is the first reported case of a lipid cell variant of ureteral UC. The overexpression of HER2 may be associated with both the lipid cell and micropapillary variants of UC.

Nonepileptic Events

2017 ◽  
Author(s):  
David K. Chen ◽  
W. Curt LaFrance
Keyword(s):  
Conversion Disorder ◽  
Evidence Based ◽  
Drug Resistant ◽  
Significant Morbidity ◽  
Psychogenic Nonepileptic Seizures ◽  
Clinical Evaluations ◽  
Evidence Based Treatments ◽  
Nonepileptic Seizures ◽  
Drug Resistant Epilepsy ◽  
Underlying Pathology

Nonepileptic events (NEE) represent important differential diagnoses in patients with neurobehavioral paroxysms, especially those with apparent drug-resistant epilepsy. Errant recognition of NEE may not only subject the patient to potential complications of unnecessary epilepsy treatment, but delay the delivery of treatment that properly addresses the underlying pathology. For many patients with NEE, such as those with the conversion disorder psychogenic nonepileptic seizures (PNES) or with physiologic NEE (e.g., cardiac-induced syncope), delays in the provision of proper treatment have been shown to be associated with significant morbidity. This review focuses on clinical evaluations aiming to enhance the recognition of the different etiologies of NEE and distinguish between NEE and epilepsy, as well as between NEE of varying pathologies. Evidence-based treatments and management of NEE, particularly those pertaining to PNES, will also be discussed.

scholarly journals Urothelial carcinoma of the bladder in a pediatric patient

2016 ◽  
Vol 10 (7-8) ◽  
pp. 268 ◽  
Author(s):  
Elke E. Mau ◽  
Michael P. Leonard
Keyword(s):  
Urothelial Carcinoma ◽  
World Health Organization ◽  
Children And Adolescents ◽  
Pediatric Patient ◽  
Bladder Tumour ◽  
World Health ◽  
Gross Hematuria ◽  
The World ◽  
Carcinoma Of The Bladder ◽  
Health Organization

Urothelial carcinoma of the bladder in children and adolescents is rare. The World Health Organization database has recorded approximately 80 patients under age 16 that have been diagnosed with papillary bladder tumour since 1968.1 We are reporting on our case of urothelial carcinoma diagnosed in a 14-year-old male who presented with painless gross hematuria.

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