Papillary Urothelial Neoplasia with Low Malignant Potential (PUNLMP) in a 9-year-old Child: A Case Report and Review of Literature
Papillary bladder tumors in children are rare. They comprise urothelial papilloma, inverted urothelial papilloma, papillary urothelial neoplasm of low malignant potential (PUNLMP), non-invasive low grade papillary urothelial carcinoma, and non-invasive high grade papillary urothelial carcinoma. PUNL...
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Cairo University, Faculty of Medicine, Department of Pediatrics
2025-01-01
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| Series: | Pediatric Sciences Journal |
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| Online Access: | https://cupsj.journals.ekb.eg/article_387126_43cb7eda609b8235fa56f5e1ee8af7fd.pdf |
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| author | Abbas Al Bazzal Amarelle Chamoun Zeinab Karaki Ibrahim Ballout Bachar Al Al Linda Chamma Hussein Issa Mohamad Moussa Hiba Hamdar |
| author_facet | Abbas Al Bazzal Amarelle Chamoun Zeinab Karaki Ibrahim Ballout Bachar Al Al Linda Chamma Hussein Issa Mohamad Moussa Hiba Hamdar |
| author_sort | Abbas Al Bazzal |
| collection | DOAJ |
| description | Papillary bladder tumors in children are rare. They comprise urothelial papilloma, inverted urothelial papilloma, papillary urothelial neoplasm of low malignant potential (PUNLMP), non-invasive low grade papillary urothelial carcinoma, and non-invasive high grade papillary urothelial carcinoma. PUNLMP are the commonest bladder tumors in children. They are typically solitary, small, non-invasive lesions that do not spread. The majority of children present with urinary bladder masses and lower urinary tract symptoms such as hematuria, dysuria, frequent urination, or urgency. Ultrasound is the first line imaging tool for assessing bladder lesions, followed by cross-sectional imaging examinations such as computed tomography or magnetic resonance imaging if the diagnosis is uncertain. The bladder tumor is typically removed through the urethra. We describe a 9-year-old boy who presented with painless gross hematuria for three months. An ultrasound revealed a left bladder tumor, which was treated with a transurethral resection of bladder tumor (TURBT) laser. Histopathology of the removed bladder tissue showed a well-circumscribed PUNLMP, with an immune-profile positive for GATA-3, p63, and CK7, and a low proliferative index. The PUNLMP recurred in the trigone of the bladder a month later. Pediatric PUNLMP is an exceptionally rare neoplasm in children with a low recurrence rate that is amenable to treatment. Pediatric PUNLMP diagnosis is to be suspected in any child with painless hematuria. Recurrence is part of the spectrum of PUNLMP. Hence, follow up of any diagnosed case with PUNLMP is imperative. Given the very small number of cases, it is difficult to determine a clear treatment and follow-up strategy; more cases and research are required to develop specific guidelines. |
| format | Article |
| id | doaj-art-ea966c6098fa4f6f89d3338eef009fa7 |
| institution | Kabale University |
| issn | 2805-279X 2682-3985 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cairo University, Faculty of Medicine, Department of Pediatrics |
| record_format | Article |
| series | Pediatric Sciences Journal |
| spelling | doaj-art-ea966c6098fa4f6f89d3338eef009fa72025-01-07T10:53:16ZengCairo University, Faculty of Medicine, Department of PediatricsPediatric Sciences Journal2805-279X2682-39852025-01-0151495410.21608/CUPSJ.2024.288863.1128Papillary Urothelial Neoplasia with Low Malignant Potential (PUNLMP) in a 9-year-old Child: A Case Report and Review of LiteratureAbbas Al Bazzal 0Amarelle Chamoun 1https://orcid.org/0000-0002-3473-8922Zeinab Karaki 2https://orcid.org/0009-0005-7732-1501Ibrahim Ballout 3Bachar Al Al 4Linda Chamma 5Hussein Issa 6Mohamad Moussa 7Hiba Hamdar8https://orcid.org/0000-0002-4488-7323Pediatrics Department, Faculty of Medical Science, Lebanese University, Beirut, LebanonPediatrics Department, Faculty of Medical Science, Lebanese University, Beirut, LebanonPediatrics Department, Faculty of Medical Science, Lebanese University, Beirut, LebanonUrology Department, Faculty of Medical Science, Lebanese University, Beirut, Lebanon - Urology Department, Zahraa Hospital University Medical Center, Beirut, LebanonUrology Department, Faculty of Medical Science, Lebanese University, Beirut, Lebanon - Urology Department, Zahraa Hospital University Medical Center, Beirut, LebanonUrology Department, Faculty of Medical Science, Lebanese University, Beirut, Lebanon - Urology Department, Zahraa Hospital University Medical Center, Beirut, LebanonUrology Department, Faculty of Medical Science, Lebanese University, Beirut, Lebanon - Urology Department, Zahraa Hospital University Medical Center, Beirut, LebanonUrology Department, Faculty of Medical Science, Lebanese University, Beirut, Lebanon - Urology Department, Zahraa Hospital University Medical Center, Beirut, LebanonEmergency Department, Notre Dame Maritime Hospital, Byblos, LebanonPapillary bladder tumors in children are rare. They comprise urothelial papilloma, inverted urothelial papilloma, papillary urothelial neoplasm of low malignant potential (PUNLMP), non-invasive low grade papillary urothelial carcinoma, and non-invasive high grade papillary urothelial carcinoma. PUNLMP are the commonest bladder tumors in children. They are typically solitary, small, non-invasive lesions that do not spread. The majority of children present with urinary bladder masses and lower urinary tract symptoms such as hematuria, dysuria, frequent urination, or urgency. Ultrasound is the first line imaging tool for assessing bladder lesions, followed by cross-sectional imaging examinations such as computed tomography or magnetic resonance imaging if the diagnosis is uncertain. The bladder tumor is typically removed through the urethra. We describe a 9-year-old boy who presented with painless gross hematuria for three months. An ultrasound revealed a left bladder tumor, which was treated with a transurethral resection of bladder tumor (TURBT) laser. Histopathology of the removed bladder tissue showed a well-circumscribed PUNLMP, with an immune-profile positive for GATA-3, p63, and CK7, and a low proliferative index. The PUNLMP recurred in the trigone of the bladder a month later. Pediatric PUNLMP is an exceptionally rare neoplasm in children with a low recurrence rate that is amenable to treatment. Pediatric PUNLMP diagnosis is to be suspected in any child with painless hematuria. Recurrence is part of the spectrum of PUNLMP. Hence, follow up of any diagnosed case with PUNLMP is imperative. Given the very small number of cases, it is difficult to determine a clear treatment and follow-up strategy; more cases and research are required to develop specific guidelines.https://cupsj.journals.ekb.eg/article_387126_43cb7eda609b8235fa56f5e1ee8af7fd.pdfpapillary urothelial neoplasia with low malignant potentialbladder cancerpunlmpsturbtpediatricspapillary urothelial neoplasiapainless hematuria |
| spellingShingle | Abbas Al Bazzal Amarelle Chamoun Zeinab Karaki Ibrahim Ballout Bachar Al Al Linda Chamma Hussein Issa Mohamad Moussa Hiba Hamdar Papillary Urothelial Neoplasia with Low Malignant Potential (PUNLMP) in a 9-year-old Child: A Case Report and Review of Literature Pediatric Sciences Journal papillary urothelial neoplasia with low malignant potential bladder cancer punlmps turbt pediatrics papillary urothelial neoplasia painless hematuria |
| title | Papillary Urothelial Neoplasia with Low Malignant Potential (PUNLMP) in a 9-year-old Child: A Case Report and Review of Literature |
| title_full | Papillary Urothelial Neoplasia with Low Malignant Potential (PUNLMP) in a 9-year-old Child: A Case Report and Review of Literature |
| title_fullStr | Papillary Urothelial Neoplasia with Low Malignant Potential (PUNLMP) in a 9-year-old Child: A Case Report and Review of Literature |
| title_full_unstemmed | Papillary Urothelial Neoplasia with Low Malignant Potential (PUNLMP) in a 9-year-old Child: A Case Report and Review of Literature |
| title_short | Papillary Urothelial Neoplasia with Low Malignant Potential (PUNLMP) in a 9-year-old Child: A Case Report and Review of Literature |
| title_sort | papillary urothelial neoplasia with low malignant potential punlmp in a 9 year old child a case report and review of literature |
| topic | papillary urothelial neoplasia with low malignant potential bladder cancer punlmps turbt pediatrics papillary urothelial neoplasia painless hematuria |
| url | https://cupsj.journals.ekb.eg/article_387126_43cb7eda609b8235fa56f5e1ee8af7fd.pdf |
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