Management of high-grade, non-muscle invasive urothelial carcinoma in a pre-pubertal patient with TURBT and intravesical BCG

High-grade urothelial carcinoma (UC) of the bladder is rare in the pediatric population with no established guidelines for management. We treated a single female patient, 10 years of age, who was found to have high-grade, non-muscle invasive UC endoscopically and with intravesical BCG.  Given the child's age, no local adult institution could provide BCG therapy. Utilizing the experience of the local adult institutions, we developed a comprehensive protocol for first-time delivery of BCG at a free-standing children's hospital. The patient has undergone successful induction and maintenance BCG for 7 cycles without disease recurrence and minimal side effects.

Urology. 2018 Oct 23 [Epub ahead of print]

James Rague, Richard S Lee

Boston Medical Center, Department of Urology, Boston MA., Harvard Medical School, Department of Surgery and Boston Children's Hospital, Department of Urology, Boston, MA.