Hacı POLAT, Murat T GULPİNAR, Gül TÜRKÇÜ, Suleyman CAKMAKCI

Adolesan ve genç erişkinlerdeki ürotelyal mesane neoplazmları

Amaç: Mesane tümörleri adolesan ve genç erişkinlerde nadir görülür. Literatürdeki çalışmalarda, genellikle bu yaş gruplarında sadece ürotelyal karsinomlar araştırılmıştır. Biz bu çalışmada, adolesan ve genç erişkinlerde görülen bütün ürotelyal mesane tümörlerini, tanı, tedavi ve prognoz açısından araştırmayı amaçladık. Hastalar ve Metod: Çok merkezli bu retrospektif çalışmada, 2008 ile 2014 yılları arasında tedavi edilen hastalar incelendi. Kırk yaş altındaki 42 hasta çalışmaya alındı. Mesane tümörleri ultrasonografi ve sistoskopi ile tanımlandı ve transüretral mesane rezeksiyonu (TUR-M) ile tedavi edildi. Bulgular: Hastaların ortalama yaşı 24.21 ±10.137 (12-24) idi. Otuz iki (%71,4) hasta makroskopik hematüri ile başvurdu. Hastaların patolojik spesmenleri şu şekilde raporlandı; 5 hastda nadir benign lezyon, 5 hastada papillom, 6 hastada düşük malignite potansiyelli ürotelyal neoplazm, 21 hastada düşük grade ürotelyal karsinom ve 5 hastada yüksek grade ürotelyal karsinom. İki hastada kas invaziv mesane kanseri vardı (pT2). Düzenli sistoskopik takipler sırasında 5 (%11,9) hastada tümör nüksü meydana geldi. Sonuç: Adolesan ve genç erişkinlerdeki mesane tümörlerinin yaklaşık %40’ı ürotelyal karsinom dışı tümörlerdir. Bu tümörlerin çoğu benign karakterde olmasına rağmen nüks etme potansiyelleri az değildir. Adolesan ve genç erişkinlerde, ürotelyal karsinomlarda olduğu gibi karsinom dışı tümörlerin de yakından takip edilmesi gerektiğini düşünüyoruz.

Anahtar Kelimeler:

benign tümörler, adolesan, hastalık yönetimi, mesane kanseri

Urothelial neoplasms of urothelial bladder in adolescent and young adult patients

Objectives: Bladder tumors are rare in adolescent and young adult patients. To date, urothelial carcinomas have usually been the only tumors investigated in these age groups. In this study, we aimed to describe the diagnosis, treatment, and prognosis of all urothelial bladder tumors in adolescent and young adult patients. Materials and Methods: This was a retrospective multicenter study involving patients who were treated between 2008 and 2014. Forty-two patients aged less than 40 years were enrolled in the study. Bladder tumors were diagnosed using ultrasonography and cystoscopy, and treated through transurethral resection of the bladder (TURBT). Results: The mean age of the patients was 24.21 ±10.137 years (range, 12-40 years). Thirty (71.4%) of the 42 patients were admitted with gross hematuria. The pathology of all patients was reported as follows: 5 with uncommon benign lesions, 5 with papilloma, 6 with papillary urothelial neoplasm of low malignant potential (PUNLMP), 21 with low-grade urothelial carcinoma, and 5 with high-grade urothelial carcinoma. Two patients had muscle invasive bladder cancer (pT2). Relapse was observed in 5 (11.9%) patients during regular cystoscopic follow-up. Conclusion: Approximately 40% of the bladder tumors in adolescent and young adult patients were not urothelial carcinomas. The majority of these tumors were benign tumors but relapse was not less frequent in these tumors. We suggest that urothelial benign tumors and urothelial carcinomas of the bladder should be closely monitored in adolescent and young adult patients.

Keywords:

benign neoplasms cancer, adolescent, disease management, follow-up,

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