Urothelial carcinoma in a child with gross hematuria: a complaint not to be dismissed

Abstract

Hematuria is not uncommonly seen among children. We describe the case of a 13-year-old boy who was diagnosed with urothelial carcinoma after presenting with persistent gross hematuria for 2 weeks. We highlight the importance of adequate workup for gross hematuria as it is often associated with an underlying pathology that could lead to significant morbidity if left undiagnosed.

Keywords: hematuria; paediatric surgery; urological cancer.

Figure 1

Ultrasound of the bladder on (A) transverse view and (B) sagittal view, showing a 2.7×1.9×1.7 cm hyperechoic lesion near the anterior wall of the bladder. Application of colour flow Doppler (C) revealed the presence of vascularity within the lesion.

Figure 2

MRI urography, with (A) T1-weighted axial image revealing the 1.8×1.6×0.9 cm polypoidal lesion arising from a stalk from the anteroinferior wall of the bladder. (B) T2-weighted coronal and (C) T2-weighted sagittal images showing the lesion within an intact T2 hypointense bladder wall with no definite invasion.

Figure 3

(A) Cystoscopic image of papillary tumour obtained during transurethral resection of bladder tumour. (B) Histology of the resected tumour showing branching papillae with a fibrovascular core, lined by urothelial cell