Ottoman Oscar, Muyeka Mohamed, Elias Edrick, Igenge John, Magambo Magreth, Mazigo Humphrey D
Department of Pathology, Bugando Medical Centre, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
Department of Urology, Bugando Medical Centre, Mwanza, Tanzania.
East Afr Health Res J. 2024;8(3):291-295. doi: 10.24248/eahrj.v8i3.796. Epub 2025 Jan 30.
Invasive squamous cell carcinoma of the urinary bladder caused by schistosomal infection is associated with aggressive complications and a poor prognosis. In schistosomiasis-endemic areas, it primarily affects adults over the age of 40 and rarely occurs in children under 15. For the first time at our hospital, we report a case of urinary bladder carcinoma associated with eggs in a 13-year-old child from northwestern Tanzania, a region endemic for .
A 13-year-old girl presented with left loin pain, turbid yellow urine, and upper limb pain for over a month. Multiple evaluations, including laboratory and ultrasonographic investigations, were conducted. Ultrasound findings revealed severe enlargement of both kidneys, with the left kidney being larger than the right. A computerized tomography (CT) scan showed severe bilateral hydronephrosis and hydroureter, likely due to vesicoureteral junction obstruction. A left nephrectomy was performed; however, the patient continued to experience dysuria. During cystoscopy, a tumor was identified on the left posterolateral wall of the bladder. Surgical exploration revealed adhesion of the tumor to the uterus, bladder neck, and cervix. A cystectomy was recommended, during which part of the right ureter was removed, and the remaining portion was anastomosed to the sigmoid colon. Histopathological examination of the tissue samples revealed invasive squamous cell carcinoma (Grade 1) involving the cervix and vaginal wall. Additionally, multiple active and calcified eggs were observed. The patient was referred to the oncology unit for radio-chemotherapy, where she continues to receive treatment.
Chronic inflammatory responses associated with Schistosoma haematobium eggs in the urinary bladder walls can lead to severe complications affecting the entire urogenital system, regardless of age. These inflammatory responses may contribute to the development of squamous cell carcinoma even in young individuals.
血吸虫感染所致的膀胱浸润性鳞状细胞癌与侵袭性并发症及预后不良相关。在血吸虫病流行地区,该病主要影响40岁以上成年人,15岁以下儿童罕见发病。我们医院首次报告了一例来自坦桑尼亚西北部一名13岁儿童的膀胱癌病例,该地区为血吸虫病流行区。
一名13岁女孩出现左腰疼痛、尿液浑浊发黄及上肢疼痛超过一个月。进行了多项评估,包括实验室和超声检查。超声检查结果显示双肾严重肿大,左肾大于右肾。计算机断层扫描(CT)显示双侧严重肾积水和输尿管积水,可能是由于膀胱输尿管连接部梗阻所致。实施了左肾切除术;然而,患者仍有排尿困难。膀胱镜检查时,在膀胱左后壁发现一个肿瘤。手术探查发现肿瘤与子宫、膀胱颈和宫颈粘连。建议进行膀胱切除术,术中切除了部分右侧输尿管,其余部分与乙状结肠吻合。组织样本的组织病理学检查显示为侵袭性鳞状细胞癌(1级),累及宫颈和阴道壁。此外,还观察到多个活的和钙化的血吸虫卵。患者被转诊至肿瘤科接受放化疗,目前仍在接受治疗。
膀胱壁中与埃及血吸虫卵相关的慢性炎症反应可导致影响整个泌尿生殖系统的严重并发症,无论年龄大小。这些炎症反应可能促使鳞状细胞癌的发生,即使在年轻人中也是如此。