NECROTURIA WITH ACUTE URINARY RETENTION: A RARE PRESENTATION OF BILATERAL WILMS' TUMOUR

Wilms' tumour is one of the most common solid abdominal tumours in children in sub-Saharan Africa. Most cases present with an asymptomatic abdominal mass. We report a 2 year old male child who presented with acute urinary retention of 6 hours duration. He had a left flank mass and ascites, with a piece of necrotic tissue protruding from the urethral meatus. The urinary retention was relieved by manual removal of the necrotic tissue and passage of a Foley's urethral catheter. Abdominal ultrasound and computed tomographic scan revealed bilateral Wilms' tumour.The child commenced neoadjuvant chemotherapy and he has made significant improvement.

This is a rare mode of presentation of bilateral Wilms' tumour which presented with a diagnostic dilemma. The need to palpate the abdomen of children who come to the hospital, cannot be over-emphasized.