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Case of bladder cancer in young patient with undiscovered risk factors- A report
Rafay Khan and associates from the Internal Medicine Department, Raritan Bay Medical Center, Perth Amboy, USA recently reported an interesting case of a young adult with no clear risk factors who was diagnosed with a rare case of mucinous adenocarcinoma of the bladder.
The study is published in the Oncology Letters.
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."
BDS, MDS( Pedodontics and Preventive Dentistry)
Dr. Nandita Mohan is a practicing pediatric dentist with more than 5 years of clinical work experience. Along with this, she is equally interested in keeping herself up to date about the latest developments in the field of medicine and dentistry which is the driving force for her to be in association with Medical Dialogues. She also has her name attached with many publications; both national and international. She has pursued her BDS from Rajiv Gandhi University of Health Sciences, Bangalore and later went to enter her dream specialty (MDS) in the Department of Pedodontics and Preventive Dentistry from Pt. B.D. Sharma University of Health Sciences. Through all the years of experience, her core interest in learning something new has never stopped. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751