Bladder Dysfunction in Children with Neurofibromatosis Type I: Report of Four Cases and Review of the Literature

Urol Int. 2018;100(3):339-345. doi: 10.1159/000487193. Epub 2018 Mar 7.

Abstract

Aim: Neurofibromatosis type 1 (NF1) is a rare autosomal dominant disorder. Malignant transformation into malignant peripheral nerve sheath tumors (MPNST) can occur. However, urinary tract involvement is rare. We report 4 cases of NF1 with bladder dysfunction.

Methods: A retrospective single center analysis of 4 patients was conducted over a 17-year period, focusing on urinary tract involvement.

Results: NF1 was diagnosed at a median of 16.5 months (4-36) and urinary involvement occurred at a median of 5.25 years (4-9) after diagnosis. Bladder dysfunction was due to spinal cord compression in 2 cases, bladder invasion in 1 case, and cerebral lesions in 1 case. Malignant transformation of neurofibromas into MPNST occurred in 2 patients. Mechanisms of urinary involvement in NF1 are diverse and no pre-established protocol of management and follow-up exists.

Conclusion: Although rare, dysfunction of the bladder can arise in NF1 and innovative strategies then need to be considered. This is best achieved with the help of a multidisciplinary team and a national reference center when available.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Brain Neoplasms / complications
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Neurofibromatosis 1 / complications*
  • Neurofibromatosis 1 / diagnosis*
  • Neurofibromatosis 1 / pathology
  • Neurofibrosarcoma / complications
  • Neurofibrosarcoma / diagnosis
  • Retrospective Studies
  • Spinal Cord Compression / complications
  • Urinary Bladder / physiopathology*
  • Urinary Bladder Diseases / complications*
  • Urinary Bladder Diseases / diagnosis*
  • Urinary Bladder Diseases / pathology
  • Urinary Incontinence / complications
  • Urinary Incontinence / diagnosis
  • Urinary Retention / complications
  • Urinary Retention / diagnosis