TITLE:
Papillary Urothelial Neoplasms in Pediatric Patients: Case Report with Proposed Tailored Follow-Up
AUTHORS:
Sebastian Tobia Gonzalez, Juan Pablo Corbetta, Leon I. Smith-Harrison
KEYWORDS:
Pediatric Urology, Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP), Bladder Tumor, Case Report, Follow-Up Protocol, Surveillance
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.16 No.1,
January
5,
2026
ABSTRACT: Objective: Urothelial tumors are exceedingly rare in children and are typically low-grade and superficial with favorable outcomes. Current pediatric management protocols are often extrapolated from adult guidelines. We present a pediatric case of papillary urothelial neoplasm of low malignant potential (PUNLMP) and propose a tailored follow-up protocol based on literature review and clinical experience. Methods: A 16-year-old male presented with painless gross hematuria and was diagnosed with a solitary papillary bladder tumor. He underwent transurethral resection (TUR) with complete excision of the lesion. Imaging, histopathology, and follow-up data were reviewed. A literature review on pediatric urothelial tumors was conducted to compare current approaches and outcomes. Results: Histopathology confirmed PUNLMP, and the patient had an uneventful postoperative recovery. A single follow-up cystoscopy with ultrasound at three months demonstrated no recurrence. Subsequent non-invasive imaging at regular intervals up to 24 months has shown no evidence of disease. Based on the favorable course of this case and the findings from our literature review, we outline a proposed surveillance protocol intended for broader application in pediatric patients. Conclusion: PUNLMP in pediatric patients has an excellent prognosis, and TUR is typically curative in most of the cases. While the long-term follow-up protocol remains undefined, we recommend an initial cystoscopy with ultrasound, followed by non-invasive imaging-based surveillance. This tailored approach may reduce the burden of invasive procedures without compromising outcomes.