High-grade urothelial carcinoma of the bladder in a 3-year-old boy: Complete resection and 18-year disease-free follow-up.

High-grade urothelial carcinoma of the bladder is exceptionally rare in children and optimal management remained undefined. We report a three-year-old boy who presented with painless gross hematuria and was found to have a papillary bladder mass. Complete transurethral resection of the bladder tumor with random bladder biopsies demonstrated high-grade urothelial carcinoma without carcinoma in situ, and metastatic evaluation was negative. Intravesical therapy was deferred and the patient underwent surveillance with cystoscopy, urine cytology, and ultrasonography. Eighteen years after diagnosis, he remains disease-free and asymptomatic. This case provides the longest reported disease-free follow-up in pediatric high-grade urothelial carcinoma.