Mixed Botryoid and Spindle Cell Bladder Rhabdomyosarcoma: An
Rhabdomyosarcoma (RMS) is a malignant tumour derived from the embryonic mesenchymal cells that subsequently differentiate into striate muscle tissue. According to the latest scientific literature, RMS represents 4–8% of the malignant tumours in pediatric age and most of them originated from the genitourinary tract, mainly in the bladder.
RMS includes a group of tumours characterized by three histological variants: embryonal RMS, alveolar RMS, and undifferentiated RMS. The embryonal RMS is divided into two different subhistological-types: Spindle Cell RMS and Botryoid RMS. Spindle Cell histology is typically found in paratesticular lesions whereas Botryoid subtypes are polypoid masses that fill the lumen of the bladder or vagina. Clinicians should be aware of the importance of the histological diagnosis in order to establish the most appropriate therapeutic regimen.

Case Presentation
A 3-year-old North African boy was admitted to our Pediatric Nephrology Unit with a 4-day history of haematuria and burning urination. The physical examination was negative for pain, palpable mass in pelvic region, or other genitourinary (GU) symptoms. Blood tests showed white blood cell count (WBC) of 8,700/mm3 with lymphocytic predominance (68%); haemoglobin of 12.4?g/dl; platelet count of 339,000/mm3; C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) within normal limits. Urinalysis revealed a gold yellow colour; pH 5.5; specific gravity 1.020; proteins 30?mg/dl; plenty of red blood cells/High Power Field, pus cells 7–10/High Power Field. Urine culture was sterile....