Hematuria: A histological surprise!

Abstract

Bladder tumors presenting with hematuria in children are rare and often raise suspicion of malignancy This child presented with painless hematuria(passage of clots) and imaging revealed a bladder mass with features of Rhabdomyosarcoma(RMS). A cystoscopy biopsy was done. Pathology examination showed no evidence of malignancy. Upfront surgical excision was performed. Intraoperative findings were more in favor of the diagnosis of RMS. However, histopathology examination revealed it was cavernous hemangioma of the bladder, a rare benign vascular tumor. There was tumor extension into muscle and perivesical fat mimicking RMS. The child recovered with minor voiding issues now remains symptom-free, and follow-up cystoscopy showed no recurrence. This case report highlights the diagnostic difficulty that can occur in a case of cavernous haemangioma of the bladder(benign), because of its close resemblance to bladder RMS(malignant).