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Neuroblastoma Causing Acute Urinary Retention: A Rare Presentation
Authors:Amy Rasmussen MD, Antonio E. Mu  iz MD, FACEP, FAAP, FAAEM,Brent King MD, FAAP, FACEP, FAAEM
Affiliation: Department of Emergency Medicine and Pediatrics, The University of Texas Health Science Center at Houston, Houston, Texas;"low Emergency Medicine Residency, The University of Texas Health Science Center at Houston, Houston, Texas
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.
Keywords:neuroblastoma   urinary retention   constipation
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