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387126

Papillary Urothelial Neoplasia with Low Malignant Potential (PUNLMP) in a 9-year-old Child: A Case Report and Review of Literature

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Last updated: 07 Jan 2025

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Abstract

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.

DOI

10.21608/cupsj.2024.288863.1128

Keywords

Papillary urothelial neoplasia with low malignant potential, Bladder cancer, PUNLMPs, TURBT, Pediatrics, Papillary urothelial neoplasia, painless hematuria

Authors

First Name

Abbas

Last Name

Al Bazzal

MiddleName

-

Affiliation

Pediatrics Department, Faculty of Medical Science, Lebanese University, Beirut, Lebanon

Email

abbas.t.bazzal@gmail.com

City

-

Orcid

-

First Name

Amarelle

Last Name

Chamoun

MiddleName

-

Affiliation

Pediatrics Department, Faculty of Medical Science, Lebanese University, Beirut, Lebanon

Email

amarellech@gmail.com

City

-

Orcid

0000-0002-3473-8922

First Name

Zeinab

Last Name

Karaki

MiddleName

-

Affiliation

Pediatrics Department, Faculty of Medical Science, Lebanese University, Beirut, Lebanon

Email

karakizynab@gmail.com

City

-

Orcid

0009-0005-7732-1501

First Name

Ibrahim

Last Name

Ballout

MiddleName

-

Affiliation

Urology Department, Faculty of Medical Science, Lebanese University, Beirut, Lebanon - Urology Department, Zahraa Hospital University Medical Center, Beirut, Lebanon

Email

ibrahim.ballout@outlook.com

City

-

Orcid

-

First Name

Bachar

Last Name

Al Ali

MiddleName

-

Affiliation

Urology Department, Faculty of Medical Science, Lebanese University, Beirut, Lebanon - Urology Department, Zahraa Hospital University Medical Center, Beirut, Lebanon

Email

bachaa1996@gmail.com

City

-

Orcid

-

First Name

Linda

Last Name

Chamma

MiddleName

-

Affiliation

Urology Department, Faculty of Medical Science, Lebanese University, Beirut, Lebanon - Urology Department, Zahraa Hospital University Medical Center, Beirut, Lebanon

Email

linda.chamma98@gmail.com

City

-

Orcid

-

First Name

Hussein

Last Name

Issa

MiddleName

-

Affiliation

Urology Department, Faculty of Medical Science, Lebanese University, Beirut, Lebanon - Urology Department, Zahraa Hospital University Medical Center, Beirut, Lebanon

Email

hussein2000lb@hotmail.com

City

-

Orcid

-

First Name

Mohammad

Last Name

Moussa

MiddleName

-

Affiliation

Urology Department, Faculty of Medical Science, Lebanese University, Beirut, Lebanon - Urology Department, Zahraa Hospital University Medical Center, Beirut, Lebanon

Email

mohamadamoussa@hotmail.com

City

-

Orcid

-

First Name

Hiba

Last Name

Hamdar

MiddleName

-

Affiliation

Emergency Department, Notre Dame Maritime Hospital, Byblos, Lebanon

Email

hiba.hamdar@live.com

City

-

Orcid

0000-0002-4488-7323

Volume

5

Article Issue

1

Related Issue

52655

Issue Date

2025-01-01

Receive Date

2024-05-11

Publish Date

2025-01-01

Page Start

49

Page End

54

Print ISSN

2805-279X

Online ISSN

2682-3985

Article File

CUPSJ_Volume 5_Issue 1_Pages 49-54.pdf

PDF . 1.2MB

Link

https://cupsj.journals.ekb.eg/article_387126.html

Detail API

http://journals.ekb.eg?_action=service&article_code=387126

Order

7

Type

Case Report

Type Code

1,279

Publication Type

Journal

Publication Title

Pediatric Sciences Journal

Publication Link

https://cupsj.journals.ekb.eg/

MainTitle

Papillary Urothelial Neoplasia with Low Malignant Potential (PUNLMP) in a 9-year-old Child: A Case Report and Review of Literature

Details

Type

Article

Created At

07 Jan 2025