Pediatric malignant bladder tumor detected antenatally #Firs
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Pediatric malignant rhabdoid tumors are a rare entity with poor prognosis. This case, published in the journal Urology presents the novel case of an antenatally detected bladder mass and the interventions that ensued. At 19 months of age, this patient has benefited from early detection and intervention and remains disease free following partial cystectomy and chemotherapy.

This patient was born to a G2T1P0A0L1 healthy 34-year-old mother with an antenatally detected bladder mass. The mother had undergone both a first trimester dating ultrasound and second trimester anatomy scan, revealing no fetal abnormalities. At 37 weeks, 5 days, decreased fetal movements triggered a repeat ultrasound and biophysical profile.

This scan indicated that the fetus, was symmetrically small for gestational age with a normal amniotic fluid volume. The biophysical profile was 8 out of 8. There was increased umbilical arterial resistance in keeping with placental insufficiency.

Of note, an echogenic 1.6 × 1.8 cm mass within the urinary bladder was detected. It was apparently avascular. Based on the findings of placental insufficiency and intrauterine growth retardation, the mother was induced and the patient was delivered at gestational age 37 weeks, 6 days.

There were no dysmorphic features and the patient's genitalia were in keeping with a normal male phenotype. A postnatal ultrasound confirmed the presence of a 1.6 × 2.2 × 3.1 cm mass occupying most of the bladder. It was mildly vascular on Dopplers and was associated with mild bilateral hydronephrosis. Creatinine was elevated on initial bloodwork to 55 umol/L and there were 6-10 RBCs/high-power field (HPF) on urinalysis.

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