Pediatric bladder mass
Number:27ESURABS0059
Type:Educational Electronic Presentation
Authors: Eduardo Bandeira, Carla Saraiva, Rita Cabrita Carneiro, Eugénia Soares
Keywords:
SECTIONS
Educational objective

To review the imaging findings of different types of bladder masses in children.


Topic Review

Urinary bladder masses are extremely rare in children. While most present with lower urinary tract symptoms, some of these masses may be identified incidentally. The first-line imaging tool for assessing bladder lesions is ultrasonography. Computed tomography and magnetic resonance imaging may be helpful when the origin of the mass is unclear and to characterize the extent of the disease.

 

Tumors arising from the bladder can originate from any of its four layers (urothelium, lamina propria, detrusor, and adventitia) and are classified as tumors with an epithelial origin (urothelial tumors) or a non-epithelial origin (mesenchymal neoplasms).

Differently from the adult population, mesenchymal bladder neoplasms are more prevalent in children (1, 2).

 

Rhabdomyosarcoma is the most common malignant tumor of the urinary bladder in children...

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Figure 1A – 15-month-old male patient with an abdominopelvic mass. Transverse color Doppler ultrasound image shows a solid mass with internal vascularity.
Figure 1B - Sagittal CT image of the same patient as in figure 1A depicts heterogeneously enhancing mass distending the bladder lumen. The histopathological result after cystectomy was consistent with embryonal rabdomyosarcoma.


Conclusions

Pediatric bladder masses are rare and have a different histologic spectrum from those seen in adults. With the exception of rhabdomyosarcomas, the majority of bladder masses in children are benign and have a favorable outcome.

The clinical presentation, the imaging appearance and location of a bladder mass are important in characterizing tumoral and non-neoplastic disease entities seen in the pediatric population.

 

 

 

 

References

1 - Shelmerdine SC, Lorenzo AJ, Gupta AA, et al.: Pearls and Pitfalls in Diagnosing Pediatric Urinary Bladder Masses. Radiographics. 2017; 37(6): 1872–91

 

2 - Huppmann AR, Pawel BR. Polyps and Masses of the Pediatric Urinary Bladder: A 21-Year Pathology Review. Pediatric and Developmental Pathology....

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