Abstract
Benign tumoral bladder tumors in children are extremely rare. The inflammatory condition determined by the presence of glandular cystitis and intestinal metaplasia, coexisting or separately, can be a determinant factor for the development of these bladder masses. Both entities have been suggested to represent a precursor for bladder adenocarcinoma. We present the case of an autistic adolescent that presented with a polypoid bladder mass and urinary tract infection. We performed a cystoscopic examination and biopsy of the tumor and due to the large dimensions and preliminary histological results we decided to perform a laparotomy and excision of the mass and bladder wall that was attached to. Post operatory evolution and follow-up showed no recurrence or progression of the dysplasia towards adenocarcinoma.
Highlights
Urinary bladder tumors in children are rare
Hemangiomas, neurofibromas, leiomyomas are the most common benign processes of the bladder and are hard to differentiate from masses derived from more frequent pathologies such as cystitis glandularis (CG) and intestinal metaplasia (IM) that associate with chronic inflammation and infection and tend to usually exist as multiple lesions [2]
We report the case of a 14-year-old girl who was diagnosed with a bladder mass that proved to be a polypoid lesion determined by the coexistence of CG and IM
Summary
Urinary bladder tumors in children are rare. The histological findings and the case prognosis for the pediatric population are very different from those in adults [1]. The patient received antibiotic treatment (amoxicillin/ clavulanate potassium and sulfamethoxazole) in the last 6 months for two episodes of urinary tract infections (UTI). She had no other medical background and did not receive any specific medication for the autism spectrum disorder. During the general anesthesia we were able to palpate the abdomen (no palpable mass), to examine the genital area that presented signs of chronic inflammation and to obtain sterile urinary samples for the lab work that revealed the presence of a urinary tract infection (E Coli). Therapeutic focus and assessment We started the antibiotic treatment for the UTI and following further discussion with the parents, a decision was made to proceed to cystoscopy under general anesthesia for evaluation and possible resection or biopsy of the lesion. Urinary tests did not show any signs of UTI
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