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Tumoral cystitis in children
M A Zulfiqar1, A M Zaleha, I Zulkifli
1Department of Radiology, Universiti Kebangsaan Malaysia.
Insights
Bladder masses in children can be caused by infections like E. coli, not just tumors. Ultrasonography can help identify these inflammatory masses, potentially avoiding invasive procedures.
Area of Science:
- Pediatric Urology
- Diagnostic Imaging
Background:
- Urinary tract symptoms like dysuria and hematuria in children warrant thorough investigation.
- Bladder masses in pediatric patients can raise concerns for malignancy, such as rhabdomyosarcoma.
Observation:
- Ultrasonography revealed bladder masses in three children aged 3-11 years presenting with urinary symptoms.
- One child underwent computed tomography, cystoscopy, and biopsy, with the biopsy revealing an inflammatory process.
- Urine cultures from the other two children identified E. coli infection.
Findings:
- Inflammatory bladder masses can mimic malignant tumors on imaging.
- Ultrasonographic features of inflammatory masses include homogeneous hypoechogenicity or moderate echoes, with smooth or lobulated mucosal surfaces.
- E. coli was identified as the causative agent in two cases.
Implications:
- Considering infectious etiologies for pediatric bladder masses is crucial.
- Early identification of inflammatory masses can help avoid unnecessary invasive investigations like computed tomography, cystoscopy, and biopsy.
- Ultrasonography plays a key role in differentiating inflammatory from neoplastic bladder masses in children.
Abstract:
Three children aged 3-11 years had ultrasonography of the urinary tract for the investigation of dysuria and haematuria. A bladder mass was seen in these 3 children. One child had computed tomography scan, cystoscopy and bladder biopsy because rhabdomyosarcoma was considered. The biopsy revealed an inflammatory process. The urine culture of the other 2 children revealed E. coli. On ultrasonography, the inflammatory mass may appear homogeneously hypoechoic or may contain moderate level echoes. The mucosal surface of the mass may be smooth or lobulated. It is important to consider an infective cause for a bladder mass in children because computed tomography, cystoscopy and biopsy may be avoided.