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Purpose: Previous radiological descriptions of pelvic rhabdomyosarcoma emphasized ultrasonography and computerized tomography (CT). Few reports are available on the use of magnetic resonance imaging (MRI) for diagnosing and following pelvic rhabdomyosarcoma. We retrospectively compared MRI to CT for diagnosing and following children with pelvic rhabdomyosarcoma., Materials and Methods: We treated 4 boys and 3 girls for pelvic rhabdomyosarcoma. Initial and followup evaluations included pelvic CT and MRI at intervals determined by treatment and disease status. We retrospectively reviewed the clinical charts and imaging studies of these patients. The initial radiological report was evaluated and then 1 radiologist reviewed all studies. Attention was directed toward identifying lesions revealed by CT or MRI but not by the other modality., Results: MRI detected all lesions shown by CT. On the other hand, MRI detected residual disease in 1 case that was not demonstrated by CT. In 2 other patients MRI was superior to CT for delineating the local extent of disease, especially urethral involvement., Conclusions: Compared with CT, MRI improves the detection of residual pelvic rhabdomyosarcoma. Tissue planes are well delineated, allowing more accurate assessment of tumor invasion into adjacent structures. MRI is the imaging modality of choice for following pediatric patients with pelvic rhabdomyosarcoma.

Pelvic tumors in children may be large, complex and of unknown origin. Preoperative radiological information regarding tumor localization and extent becomes essential in these cases for proper staging and surgical planning. Magnetic resonance imaging (MRI) offers the ability to enhance the surgical preparation of children who present with a pelvic mass. Advantages of MRI over computerized tomography include improved soft tissue characterization, signal enhancement of neuroendocrine tumors and multiplanar imaging. These features better define the origin, size and extent of tumors. In addition, no ionizing radiation is required. Several examples of pelvic tumors are presented. The new anatomical information provided by MRI altered surgical planning previously based on computerized tomography findings alone.

We report an unusual case of long-standing bladder outlet obstruction due to pelvic lipoma in a 31-year-old white man. The mass was evaluated by plain film, computerized tomography and magnetic resonance imaging. The differential diagnosis of fat-containing extraperitoneal pelvic masses is discussed.

We describe 2 neonates with bladder outlet obstruction secondary to presacral teratoma. The clinical course and investigations are discussed to illustrate the errors made and difficulties experienced in making this diagnosis. The value of routine rectal examination in all neonates who present with lower urinary tract obstruction is stressed.

The fifth male patient with a congenital arteriovenous fistula of the pelvis is described. This disorder has been reported previously in 11 female patients. Most patients gave a long history of symptoms before a diagnosis was made. Preoperative angiography is vital to delineate the vascular supply to the fistula and operative treatment consists of ligation of the feeding vessels and resection of the fistula.

Followup of 5 cases presented in 1971 and report of 8 additional cases confirm the initial conclusions that pelvic lipomatosis is a benign but potentially progressive process leading to ureteral obstruction. Young black subjects are affected most commonly. More than 40 per cent of the patients have required permanent urinary diversion.

We describe a case of a solitary pelvic kidney coexisting with adrenal and pelvic neuroblastoma in a child with multiple malformations, including microcephaly, hypertelorism, aortic coarctation and a bifid uterus. The association of a solitary kidney and neuroblastoma has not been reported previously.

A case is presented in which an irregular pattern of extravasation of contrast medium was observed during excretory urography. This proved to be extravasation into the necrotic center of a neoplasm. The differential diagnosis of extravasation during excretory urography is discussed.

Three cases of lymphocysts occurred in a series of 97 patients undergoing extension pelvic urological operations, an incidence rate of 3.1 per cent. This is the first report of this complication after urological lymphadenectomy. Awareness of the entity is important to urologists since lymphatic staging operations for prostate and bladder carcinoma are widely used to help plan definitive therapy. Athough this complication is rare after renal transplantation it may cause significant interference with graft function. The etiology, symptoms, findings, diagnosis and treatment of this condition are reviewed. Echography is presented as an ideal technique to diagnose the condition and to guide in its management.

From 1950 through 1985, 18 patients 26 to 65 years old (mean age 44.5 years) presented with pelvic lipomatosis. Followup ranged from 6 months to 17 years, with a mean of 7.5 years. Of these 18 patients 16 (89 per cent) are alive, 1 (6 per cent) died of uremia and 1 (6 per cent) was lost to followup after 6 months. During this period 7 patients (39 per cent) required operative procedures for urinary obstruction. Although pelvic lipomatosis is a benign proliferation of fat in the true pelvis that is known to lead to urinary tract, fecal and even vena caval obstruction, it also may remain dormant and cause no significant symptoms for many years.

Diagnostic ultrasound for pelvic masses is now a well established modality. Its ability to distinguish between fluid-filled and solid lesions is important in the diagnostic study of pelvic masses. Two cases are presented of bladder distension causing clinical symptoms suggesting pathology outside the urinary tract, which when finally evaluated by ultrasound proved bladder distension as the etiology of the symptoms.

We report a case of pelvic lipomatosis with ureteral obstruction and vesicoureteral reflux. In addition to computerized tomography, nuclear magnetic resonance imaging provided definite and graphic proof of the diagnosis. Operative treatment consisted of ureteroileocystostomy.

Neuroblastoma usually presents as an upper abdominal mass arising from the adrenal gland. Recent experience with neuroblastoma of the spermatic cord, bladder and pelvis demonstrates the propensity of this tumor to arise in unusual areas. The need for unusual and unexpected masses in children to be evaluated thoroughly for neuroblastoma and for therapy to be individualized based on histological criteria, patient age and location of the tumor is demonstrated.