Epithelial and Mesenchymal Urinary Tract Lesions in Patients ≤30 Years of Age
ST Chuang, M Zhou, C Magi-Galluzzi, DE Hansel. H Lee Moffitt Cancer Center, Tampa, FL; Cleveland Clinic, Cleveland, OH
Background: Genitourinary lesions are infrequently diagnosed in children and young adults, with previous reports primarily focusing on epithelial lesions within the bladder. We examined all pathological diagnoses, including non-neoplastic and neoplastic epithelial and mesenchymal lesions, diagnosed in patients ≤30 years of age at the Cleveland Clinic to determine the most common diagnostic entities within this demographic.
Design: We searched the pathology database for urinary tract diagnoses reported in patients under age 30 between 1981-2008. Patients were separated into 5-year age increments and pathological diagnoses were categorized by site as non-neoplastic vs neoplastic, benign vs malignant, and epithelial vs mesenchymal.
Results: A total of 507 patients (304 male:203 female) was identified. Specimens included bladder (n=211), urethra (n=108) and upper tract/ureter (n=188). Most commonly represented groups included patients aged 0-5(n=118), 26-30(n=107), and 21-25(n=95). Overall, the most frequent diagnoses included non-neoplastic conditions, including ureteral stricture, diverticula, inflammatory polyps, and nephrogenic adenoma, as well as non-specific reactive changes. Condylomas were the most common diagnosis in the urethra of patients aged 16-30 years (n=28/85;33%). Fourteen epithelial and 12 mesenchymal neoplasms were identified. Epithelial neoplasms consisted of 1 papilloma, 3 inverted papillomas, 1 PUNLMP, 6 low grade urothelial carcinomas, and 3 adenocarcinomas and were exclusively identified in patients between 16 to 30 years of age (4, 16-20 years; 6, 21-25 years; 4, 26-30 years) and were situated primarily in the bladder (n=12). The 12 mesenchymal neoplasms consisted of 1 neurofibroma, 1 ganglioneuroblastoma, 1 hemangioma, 1 inflammatory myofibroblastic tumor, 2 pheochromocytomas, 1 rhabdomyosarcoma, 2 embryonal rhabdomyosarcomas, 1 malignant peripheral nerve sheath tumor and 1 leiomyosarcoma. These lesions were identified in virtually all age groups and were again bladder-predominant.
Conclusions: Genitourinary specimens are infrequent in the pediatric to young adult population. Although the vast majority of lesions are non-neoplastic, both epithelial and mesenchymal neoplasms appear to occur with relatively equal frequency in this population, with distinction by age subclassification. The results from this study can serve as a useful guide to the most common entities diagnosed in the urinary tract by both age and site stratification.
Category: Genitourinary (including renal tumors)
Tuesday, March 23, 2010 1:00 PM
Poster Session IV # 102, Tuesday Afternoon