BLADDER EMBRYONAL RHABDOMYOSARCOMA IN AN 18-MONTHS-OLD BOY: A CASE REPORT

Abstract

Objective: This study aims to report a case of bladder embryonal rhabdomyosarcoma in an 18-months-old boy. Case(s) Presentation: An 18-months-old boy presented with complaint of difficult urinating since the last 2 months before presentation. It was accompanied with hematuria, blood clot and palpable mass in the lower abdomen. Magnetic resonance imaging (MRI) of lower abdomen showed a solid mass in the inferior bladder wall, involved bilateral ureterovesical junction (UVJ) that caused bilateral severe hydroureteronephrosis, lymphadenopathy, and multiple nodul in both lungs. Cystoscopy was performed and found intrabladder tumor near the bladder neck and trigonum. Then biopsy of the bladder tumor was performed. Pathology result of the specimens showed bladder embryonal rhabdomyosarcoma. Then immunohistochemistry examination was performed with desmin and myogenin antibody to confirm bladder embryonal rhabdomyosarcoma diagnosis. Discussion: Bladder embryonal rhabdomyosarcoma often involves the bladder neck and trigone. In general, clinical symptoms relate to mass and blockage caused by mass. Ultrasound is the first imaging examination performed. Magnetic resonance imaging (MRI) helps depict the mass, usually hyperintense on the T2 image. The immunohistochemical examination is an important examination of skeletal muscle markers. Desmin found in muscle is used to diagnose rhabdomyosarcoma. Conclusion: Bladder embryonal rhabdomyosarcoma is a diagnostic challenge as it is a rare malignant tumor. The clinician needs to be aware of this entity and performed immunohistochemistry as an important examination to accurately diagnose embryonal rhabdomyosarcoma of the bladder.
 Keywords: Bladder, immunohistochemistry, rhabdomyosarcoma.