Amy Rasmussen1, Antonio E Muñiz, Brent King. 1. Emergency Medicine Residency, The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA.
Abstract
BACKGROUND: Neuroblastoma is the most common extracranial solid tumor in children under the age of 5 years and, after acute lymphoblastic leukemia, is the second most prevalent malignancy in childhood. Acute urinary retention is rare in children, especially due to a neuroblastoma. OBJECTIVES: To present the potential complications of a pelvic neuroblastoma. CASE REPORT: A 9-month-old infant presented with urinary retention that had been attributed in the past to the infant's chronic constipation. She was catheterized and a large residual of urine was obtained; she was discharged home. She returned the following day with the same complaint. Plain radiographs suggested a soft tissue density in the pelvic region with no evidence of constipation. Rectal examination revealed a mass, and a computed tomography scan showed a large, solid mass. Pathological examination confirmed a pelvic neuroblastoma, which was resected. CONCLUSIONS: The most common causes of acute urinary retention are urinary tract infections, lower urinary stones, neurologic processes, trauma, and constipation. A detailed and focused history and physical examination can be very helpful in diagnosing a pathological cause of urinary retention, such as a pelvic neuroblastoma.
BACKGROUND:Neuroblastoma is the most common extracranial solid tumor in children under the age of 5 years and, after acute lymphoblastic leukemia, is the second most prevalent malignancy in childhood. Acute urinary retention is rare in children, especially due to a neuroblastoma. OBJECTIVES: To present the potential complications of a pelvic neuroblastoma. CASE REPORT: A 9-month-old infant presented with urinary retention that had been attributed in the past to the infant's chronic constipation. She was catheterized and a large residual of urine was obtained; she was discharged home. She returned the following day with the same complaint. Plain radiographs suggested a soft tissue density in the pelvic region with no evidence of constipation. Rectal examination revealed a mass, and a computed tomography scan showed a large, solid mass. Pathological examination confirmed a pelvic neuroblastoma, which was resected. CONCLUSIONS: The most common causes of acute urinary retention are urinary tract infections, lower urinary stones, neurologic processes, trauma, and constipation. A detailed and focused history and physical examination can be very helpful in diagnosing a pathological cause of urinary retention, such as a pelvic neuroblastoma.