Rare case of primary bladder Wilm's tumor in a 1-year old boy

Abstract

Extrarenal Wilms' tumor (EWRT) is a rare entity, but primary bladder Wilm's tumor is even rarer with only 1 case reported. A 1-year old boy came with chronic urinary retention. Abdominal pelvic CT scan revealed intravesical mass arising from anterior bladder wall extending to the prostate and bladder neck. Initial cystoscopic diagnosis revealed chronic granuloma. We decided to perform partial cystectomy with final pathologic result of bladder Wilms' tumor. EWRT may occur in various organs, but primary bladder Wilms' tumor is extremely rare case.

Primary Wilms tumor of the urinary bladder

“…7 The previously reported primary urinary bladder WT cases were seen in three male children (8 months,1 year, and 6 years old). [3][4][5] The index patient presented at the age of 4 years. The clinical presentation of ERWTs usually depends on the location and stage of the tumor.…”

“…The index case presented with bladder symptoms like the other reported cases. [3][4][5] As the symptoms are not in concordance with classical WT a clinical diagnosis cannot be made, and the diagnosis of ERWT is achieved on histopathological examination.…”

“…10,11 We came across a case of WT with heterologous differentiation that has not been reported in the previous case reports of primary urinary bladder WT. [3][4][5] Differentiating nephrogenic rests (NR) from the ERWT is not an easy task as the described histological criteria in the literature are not conclusive, especially in a postchemotherapy specimen. Even no definite molecular studies are available.…”

“…Similarly, NR was not identified even in the reported cases of primary bladder WTs. [3][4][5] There are no accepted staging or treatment guidelines for ERWT. However, as per the National Wilms Tumor Study (NWTS), all ERWTs are considered Stage II or higher.…”

“…The other two cases reported the urinary bladder as the primary site while the kidneys were uninvolved. 4,5 Herein, we present another rare case of primary extrarenal WT in a 4-year-old-female child with urinary bladder as the primary site for WT and no evidence of renal involvement.…”