Neuroblastoma of the urinary bladder in an infant clinically detected by hematuria

✍ Scribed by S�ez, Carmen ;M�rquez, Catalina ;Quiroga, Eduardo ;Borderas, Felipe ;Alfaro, Jos� ;Pineda, Gregorio ;Loizaga, Juan M. ;Alvarez, Ana M.

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 485 KB
• Volume: 35
• Category: Article
• ISSN: 0098-1532
• DOI: 10.1002/1096-911x(20001101)35:5<488::aid-mpo8>3.0.co;2-e

✦ Synopsis

Pediatric Oncologist) The tumor board today concerns a child with a solitary mass in the anterior wall of the urinary bladder. This in my experience is an extremely rare case that presented an interesting problem in management.

Dr. Ma ´rquez, will you present the case? Catalina Ma ´rquez, MD (Pediatric Oncologist) This 3-month-old male infant without relevant familial history of disease was seen because of macroscopic hematuria. On physical examination his general condition was good except for skin and mucosal pallor. The abdomen was free of palpable masses or organomegaly, and the external genitalia were normal. Routine laboratory examination showed a normal complete blood count.

Dr. Quiroga, can you describe the radiographic and echocardiographic findings?

Eduardo Quiroga, MD (Pediatric Oncologist) Imaging studies were reported as follows: the chest roentgenogram was normal. Abdominal echography and CT scan disclosed a solitary mass in the anterior wall of the urinary bladder, protruding into the bladder lumen (Fig. ). Rhabdomyosarcoma seemed to be the most likely diagnosis but surgery was thought to be necessary for definitive diagnosis and therapy, and the tumor was excised completely.

Dr. Borderas, can you explain the histopathology? Felipe Borderas, MD (Pathologist) The findings were a surprise. It proved to be a poorly differentiated neuroblastoma. The tumor was 2 cm in size. Microscopically there were sheets of small cells with frequent mitoses and karyorrhectic bodies, and vague, occasional rosette-like structures, with high mitosis/karyorrhexis index (Fig. ). According to the criteria of Shimada et al. the tumor could be classified as unfavorable (a stroma-poor, undif-