Rare presentation of recurrent eosinophilic cystitis in a child

Eosinophilic cystitis (EC) is a rare presentation in childhood, with just over 100 cases reported in the literature. It often presents with haematuria and irritative lower urinary tract symptoms (LUTS) including frequency, urgency and dysuria. EC can be treated conservatively or surgically. We present a case of an early adolescent male patient who presented with dysuria and haematuria. An ultrasound scan and MRI revealed a lesion in the bladder wall raising the suspicion of malignancy. The initial biopsy was inconclusive, and so imaging was repeated a month later, showing the bladder mass had altered in position, which was confirmed at cystoscopy. Biopsy confirmed the diagnosis of EC. Symptoms resolved, but the patient represented 3 years later with irritative LUTS, haematuria and a left-sided bladder mass on imaging. Biopsy confirmed a reoccurrence of EC and he was managed successfully with oral steroids.