CASE REPORT
Urological and nephrological problems in neurofibromatosis type 1 – a case report and review of literature
More details
Hide details
1
Klinika Nefrologii Dziecięcej, Uniwersytet Medyczny w Lublinie
Med Og Nauk Zdr. 2013;19(1):64-67
KEYWORDS
ABSTRACT
Introduction:
Neurofibromatosis type 1 (NF1) is an autosomal dominant condition that occurs at an incidence of 1/3,000 live births. The characteristic features are skin lesions known as café-au-lait macules, neurofibromas of any type, plexiform neurofibroma, freckling in the axillary or inguinal regions, optic glioma, Lisch nodules and a distinctive osseous lesion. Urinary tract involvement of neurofibromatosis is rare, and was reported in approximately 70 cases mainly with involvement of the urinary bladder; only 25 cases concerned the paediatric population.
Case report:
The case is presented of an 11-year-old boy with NF1, with the diagnosis of tumour of the abdominal cavity that had infiltrated the posterior wall and triangle of the urinary bladder. A double collecting system with third degree vesico-urinary reflux on the right side was additionally discovered. Voiding disorders that were not observed at the beginning appeared later. The patient had reduced bladder volume with abnormal uroflowmetry test. In the follow-up, dysfunction of the right kidney was observed.
Conclusions:
The case is presented due to the rare location of the plexiform neurofibroma that leads to lower urinary tract dysfunction and gradual disturbances of kidney function. The management of patients with plexiform neurofibroma is not well defined, and in the case of our patient will probably require cystectomy.
REFERENCES (16)
1.
Gutmann DH, Consensus Group. The diagnostic Evaluation and Multidisciplinary Management of Neurofibromatosis 1 and Neurofibromatosis 2. J Am Med Ass. 1997; 278: 51-7.
2.
Stenzel A, Kostuch M, Wojciechowski J. Nerwiakowłokniakowatość typu 1 – choroba Recklinghausena; patogeneza i klinika. Med Wieku Rozwoj. 1999; 3: 41-46.
3.
Brasfield RD, Das Gupta TK. Von Recklinghausen`s disease: a clinicopathological study. Ann Surg. 1972; 175: 174-83.
4.
Blum MD, Bahnson RR, Carter MF. Urologic manifestation of Von Recklinghausen neurofibromatosis. Urology. 1985; 26: 209-17.
5.
Nunes TF, Costa RP, Navarro FC. Von Recklinghausen`s disease with urological manifestation. International Braz J Urol. 2005; 31: 153-154.
6.
Scheithauer BW, Santi M, Richter ER, Belman B, Rushing EJ. Diffuse ganglioneuromatosis and plexiform neurofibroma of the urinary bladder: report of a pediatric example and literature review. Human Pathol. 2008; 39: 1708-1712.
7.
Hintsa A, Lindell O, Heikkila P. Neurofibromatisis of the bladder. Scan J Urol Nephrol. 1996; 30: 497-499.
8.
Reynolds RM, Browning GGP, Nawroz I, Campbell IW. Von Recklinghausen `s neurofibromatosis: neurofibromatosis type 1. Lancet. 2003; 361: 1522-1559.
9.
Wigler MH. Oncoproteins. GAPs in understanding Ras. Nature. 1990; 346: 696-697.
10.
Bernards A. Neurofibromatosis type 1 and Ras-Mediated Signalling: Fitting in the GAP`s. Bioch Bioph Acta. 1995; 1242: 43-59.
11.
Rallis E, Ragiadakou D. Giant plexiform neurofibroma in a patient with neurofibromatosis type 1. Dermatol Online J. 2009; 15(5): 7.
12.
Cheng L, Scheithauer BW, Leibovich BC, Rammani DM, Cheville JC, Bostwick DG. Neurofibroma of the urinary bladder. Cancer. 1999; 86: 505-513.
13.
Nguyen HT, Kogan BA, Hricak H, Turzan C. Plexiform neurofibroma involving the genitourinary tract in children: case reports and review of the literature. Urology. 1997; 49(2): 257-60.
14.
Aygun C et al. Neurofibroma of the bladder wall in von Recklinghausen`s disease. Int J Urol. 2001; 8: 249-253.
15.
Matuszczak E, Kirejczyk JK, Skobudzińska-Jaźwińska H. Trudności diagnostyczne w chorobie Recklinghausena- doświadczenia własne. Przeg Pediatr. 2006; 36(1): 238-241.
16.
Rapado F, Simo R, Small M. Neurofibromatosis type 1 of the head and neck: dilemmas in management. J Laryngol Otology. 2001; 115: 151-155.