Case of bladder cancer in young patient with undiscovered risk factors- A report

Bladder cancer is one of the most common forms of malignancies involving the urinary system and multiple risk factors have been associated with its etiology. The most common of which include cigarette smoking and various occupational or chemical exposures. It is usually diagnosed in older individuals with an average age of 70. In rare cases it is observed in children as well as young adults where it usually presents as a low grade, non invasive disease.

The authors studied a 27 year old male patient who presented with no significant risk factors and was treated for mucinous adenocarcinoma of the bladder while further investigations were performed to identify other associated factors related to this form of malignancy.

Following diagnosis, cystoscopy with transurethral resection of bladder tumor was performed with insertion of a right ureteral stent and bladder biopsies were taken. However, complete resection of the tumor was not possible due to the extensive nature of the tumor. Following dome-biopsy, a diagnosis was made of urachal primary mucinous adenocarcinoma with prominent signet ring features and extension into the subepithelial connective tissues. The tumor was staged at pT1.

The authors discussed that the patient presented with painless hematuria, which is the most common symptom, however the patient's history did not demonstrate a clear correlation with any significant risk factor that may suggest the emergence of bladder cancer.

Although the oncogenesis of urothelial tumors in young patients is unclear, multiple environmental and genetic factors may contribute to the etiology. The amount of tobacco smoking and certain occupation exposure have been documented to be known risk factors for urothelial tumors. The causes of bladder cancer in the young age group however have not been well reported in the literature. Furthermore, further research should determine whether a young patient diagnosed with bladder cancer with tumor markers may necessitate early colonoscopy screening.

Hence, they concluded that "a patient under the age of 30 with no past medical history, a non-smoker, and little exposure in the work space presenting with such symptoms demonstrates the unclear etiologies of this form of malignancy, which are yet to be fully studied and brings into question whether there is any association with bladder cancer and the development of other cancers."