Case 5 :

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A 12-year-old male presented with history of difficulty in passing urine with intermittent retention of 2 months duration. There was no history of fever or pain. Following investigations have been performed. 
What is the diagnosis? 

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Imaging Findings
Study shows a solid echopoor mass in the prostate on USG. CT also confirms a prostatic mass. MCU shows elongation of the posterior urethra, with no filling defects within.

Prostatic rhabdomyosarcoma.

Rhabdomyosarcoma, a soft tissue tumour is commonly seen in infancy and in the pediatric age group. It is seen commonly arising from the floor of the urinary bladder, but could also arise from the prostate, vagina, testis or pelvic floor.

Histologically, they are of 3 types:
Embryonal , alveolar and pleomorphic.

Embryonal rhabdomyosarcomas are bulky aggressive tumors with propensity for local invasion, and can show lymphatic and hematogenous dissemination. Contiguous spread can lead to hematuria (due to bladder mucosal ulceration), involvement of ureteral orifices (hydronephrosis) and invasion into perivesical tissues.

Rhabdomyosarcoma of the urinary bladder. Bapat-Amonkar GPB. Ind J Radiol Imaging 1997; (7) 2: 115-16.

Dr Ravi Kadasne