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Cleft palate, arachnoid cyst and posterior urethral valve

Sanwar Agrawal1, Anju Parakh, Arun Agrawalla

  • 1Department of Pediatrics, Ekta Institute of Child Health, Raipur, India. drsanwar50@gmail.com

BMJ Case Reports
|July 11, 2012
PubMed

Insights

A rare case presents a 5-month-old infant with cleft palate, urinary tract issues including posterior urethral valve and vesicoureteric reflux, and a brain arachnoid cyst causing hydrocephalus. These conditions appear to be unrelated coincidental findings.

Area of Science:

  • Pediatric Medicine
  • Neurology
  • Urology

Background:

  • Infants can present with complex congenital anomalies.
  • Urinary tract abnormalities and neurological conditions can occur independently.

Observation:

  • A 5-month-old infant exhibited cleft palate, febrile urinary tract infection, and abnormal movements.
  • Poor urinary stream led to the diagnosis of posterior urethral valve and grade V vesicoureteric reflux.
  • Cerebral MRI revealed a large arachnoid cyst causing significant ventricular dilatation and third ventricle compression.

Findings:

  • The patient presented with a rare triad of congenital anomalies: posterior urethral valve, severe vesicoureteric reflux, and a large intracranial arachnoid cyst.
  • The arachnoid cyst's mass effect led to obstructive hydrocephalus, indicated by dilated ventricles.
  • The coexistence of these three distinct abnormalities in a single infant is highly unusual.

Implications:

  • This case underscores the importance of thorough investigation in infants with seemingly unrelated congenital anomalies.
  • Multidisciplinary management is crucial for addressing complex pediatric cases involving urological and neurological systems.
  • The etiology of such co-occurring conditions remains unclear, suggesting potential chance findings or complex developmental interactions.

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