Cavernous hemangioma of the bladder in a child of 6 years and 11 months

Abstract

We analyze a clinical case of the patient at the age of 6 years and 11 months with a cavernous hemangioma of the bladder. The disease manifested with isolated macrohaematuria. During the diagnostic assessment by 3D-ultrasound examination of the urinary tract with tight bladder filling, a mass with tuberous shape and echonegative areas inside was visualized on the left bladder wall close to its anterior surface, while external bladder contours were unchanged. Color Doppler mapping showed some vessels in the projection of the mass sprouting from the muscular layer of the bladder. The neoplasm was confirmed by abdominopelvic magnetic resonance imaging (with and without contrast enhancement) and by cystoscopy. Taking into account familial cancer history of the patient (oncological disorders in the maternal and paternal lines) and high degree of vascularization of the mass, a malignancy (rhabdomyosarcoma) was deemed highly probable. At 2 months after the disease manifestation, transurethral endoscopic surgery was performed with coagulation and a resection of an exophytic mass of 1 cm in diameter, with a wide base, irregular tuberous shape, brown colored, with a cystic component. The mucous layer on the lateral bladder wall was abnormal with some hemorrhages. Histological examination of the tissue sample showed a cavernous hemangioma, that was the final diagnosis in this patient. During subsequent 2-year follow up, there was no recurrence of the disease. The described case is of clinical interest because bladder hemangiomas are rare in children; therefore, this disease should be on the list for differential diagnosis in children with macrohaematuria.