Characteristics of bladder neoplasms in the young population of Saudi Arabia

Context: Bladder neoplasms are a well-studied subject in medicine. However, the evidence of bladder neoplasms in children and the young adult population (≤40 years), particularly in Saudi Arabia, is lacking. Aims: The aims of this study were to identify histopathological characteristics as well as clinical features, prognosis, and treatment of bladder neoplasms in this age group in a single tertiary referral center, Riyadh, Saudi Arabia. Settings and Design: A retrospective cohort study. Materials and Methods: Children and young adults (≤40 years) diagnosed with epithelial and mesenchymal bladder neoplasms from 1994 to 2017. Statistical Analysis Used: Descriptive data are presented as mean (standard deviation) or median (interquartile range) for continuous variables and n (%) for categorical variables. Statistical Package for Social Sciences version 23 was used. Results: Thirty-eight cases were identified. The majority, 71.1% ( n = 27) were male. The median age of diagnosis was 33 years ranging from 1 to 40 years. Nearly 45% ( n = 17) were smokers. Macroscopic hematuria was present in 57.8% ( n = 22). The most common histopathology was papillary urothelial carcinoma ( n = 18, 58%). All mesenchymal neoplasms accounted for 18.4% ( n = 7). Of all malignancies, 63.2% ( n = 24) and 44.7% ( n = 17) were low stage and low grade, respectively. Transurethral resection of bladder tumor (TURBT) was conducted for 81.6% ( n = 31). The mean length of follow-up was 36.05 months (±39.4 months). Recurrence occurred in 15.8% ( n = 6) and 7.9% ( n = 3) had progression. Distant metastasis was reported in 5.3% ( n = 2). Nearly 8% ( n = 3) died during their follow-up. Conclusions: Bladder malignancies at the early fourth decade of life tend to be a low stage and low grade. The most common histopathology was papillary urothelial carcinoma. Management should be based on the clinical and histopathological features. However, most of the patient underwent TURBT.