Pediatric inflammatory bladder tumors: Myofibroblastic and eosinophilic subtypes

Purpose: Benign bladder tumors are rare in children. A number of descriptiv e terms have previously been used to describe inflammatory tumors with myof ibroblastic proliferation or eosinophilic infiltration. We present our expe rience with these tumors and review the literature. Materials and Methods: We retrospectively reviewed the records of all child ren presenting with a benign focal bladder mass during the last 5 years, in cluding 2 girls and 3 boys 2 to 12 years old (mean age 7). Results: Presenting symptomatology included irritative voiding symptoms, su prapubic pain and hematuria. All bladder masses were diagnosed by ultrasono graphy and all patients underwent transurethral resection. Three children w ho had an inflammatory bladder tumor with myofibroblastic features required open tumor excision with preservation of the bladder. In the 2 remaining c hildren urine culture was positive preoperatively and the diagnosis was an inflammatory bladder tumor with eosinophilic infiltration. Transurethral re section of the mass was performed without partial cystectomy. Conclusions: Inflammatory myofibroblastic and eosinophilic tumors represent forms of focal cystitis with a tumefactive component. Differentiation from the malignant bladder neoplasms of childhood has important consequences fo r therapy. Management of these benign but aggressive inflammatory lesions i nvolves local control by endoscopic or open surgery with bladder preservati on. We encourage refined use of the terminology for inflammatory myofibrobl astic and eosinophilic tumors.