Leiomyoma of the bladder in a child

Abstract

Bladder neoplasms are not common tumours of childhood, and of those reported, most were malignant (Berkmen, 1965; Deming, 1924; Ganem and Ainsworth, 1955; Tucker and Persky, 1970). A child with a benign cellular leiomyoma was recently treated at our hospital. The rarity of the lesion and the radiographic characteristics that initially suggested malignancy prompt this case report. An 11-year-old Negro girl had a history of intermittent enuresis and gross haematuria for five months. The initiating factor, ostensibly, was a kick to her left side. A urinalysis during this interval had shown no evidence of haematuria. On admission the physical findings were within normal limits. There was gross haematuria and moderately severe anaemia (Hgb. 9·1 g/100 ml.). A cystogram, obtained shortly after admission, demonstrated an irregular polypoid mass, approximately 3·5 × 2·5 cm in size, which arose from the left posterior wall of the bladder (Fig. 1). A subsequent urogram failed to demonstrate the collecting system and ureter on the left side, although the outline of the left kidney was seen (Fig. 2). A rhabdomyosarcoma with invasion of the left distal ureter and complete left-sided urinary obstruction was considered the most likely diagnosis. At cystoscopy, a large polypoid tumour was seen to obscure the left ureteric orifice, and a smaller sessile mass was situated near the right ureteric orifice.