GENITOURINARY IMAGING: Collecting System, Ureter, Bladder
Case Author: Rupan Sanyal, MD, University of Alabama at Birmingham
History
26-year-old woman with pelvic pain and multiple skin lesions.
Imaging Findings
Axial (A) and coronal (B) contrast-enhanced CT images show severe diffuse bladder wall thickening. Axial bone window CT image (C) shows widening of the sacral neural foramen (arrow).
Axial CT image (D) obtained 5 years before A–C shows similar diffuse bladder wall thickening.
Diagnosis
Plexiform neurofibroma involving the bladder wall in a patient with neurofibromatosis type 1
Teaching Points
Attention to history, comparison studies, and ancillary findings such as a widened neural foramen can make a rare and difficult diagnosis simple.
Neurofibromas can occur in any organ of the body. They can originate from the rich somatic and autonomic nerves supplying abdominal and pelvic organs.
Abdominal neurofibromas tend to be permeative and infiltrative.
Malignant degeneration of neurofibromas is rare. Progressive tumor enlargement and pain related to the mass are findings that raise the possibility of malignant degeneration.
Suggested Readings
Fortman BJ, Kuszyk BS, Urban BA, Fishman EK. Neurofibromatosis type 1: a diagnostic mimicker at CT. RadioGraphics 2001; 21:601–612
Zacharia TT, Jaramillo D, Poussaint TY, Korf B. MR imaging of abdominopelvic involvement in neurofibromatosis type 1: a review of 43 patients. Pediatr Radiol 2005; 35:317–322
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