Child Kidney Dis.  2019 Oct;23(2):116-120. 10.3339/jkspn.2019.23.2.116.

Bilateral Ureteral Obstruction Related to Pelvic Rhabdomyosarcoma Presenting with Acute Kidney Injury: A Case Report

• Han S
• Han KH

• KMID: 2464937
• DOI: http://doi.org/10.3339/jkspn.2019.23.2.116

Abstract

Bilateral renal obstruction is a rare critical condition, requiring a prompt diagnostic approach and treatment to restore the renal function. The most commonly observed obstructive uropathy in children is congenital malformation, such as posterior urethral valves and bilateral ureteropelvic junction obstruction. Malignant pelvic masses obstructing the ureter are widely reported in adults but are rarely observed in children. The treatment of ureteral obstruction related to pelvic malignancy is a therapeutic challenge with a median survival duration of 3-7 months in adults; however, pediatric patients with pelvic malignancy leading to ureteral obstruction had better outcomes, with a reported 5-year mortality rate of 20%, than the adult patients. Here, we report a rare case of bilateral ureteral obstruction associated with pelvic rhabdomyosarcoma presenting with acute kidney injury treated by ureteral diversion with double J stent, and concommittent emergency hemodialysis, leading to restoration of good renal function. We suggest that bilateral ureteral obstruction should be released as soon as possible using surgical or interventional approach to minimize the obstruction period, and subsequential chemotherapy may contribute to improvement of survival and recovery of renal function.

Keyword

Urinary bladder neck obstruction; Acute kidney injury; Child; Pelvic Neoplasms; Prognosis

MeSH Terms

Acute Kidney Injury*
Adult
Child
Drug Therapy
Emergencies
Humans
Mortality
Pelvic Neoplasms
Prognosis
Renal Dialysis
Rhabdomyosarcoma*
Stents
Ureter*
Ureteral Obstruction*
Urinary Bladder Neck Obstruction