Leukemic infiltration of the urinary bladder presenting as uncontrollable gross hematuria in a child with acute lymphoblastic leukemia

Acute leukemia can result in leukemic infiltration of many organs, but leukemic infiltration of the bladder is rare. The authors describe an 8-year-old girl with acute lymphoblastic leukemia who, during marrow relapse, had uncontrollable gross hematuria secondary to leukemic infiltration of the bladder. Cystoscopic biopsy confirmed the diagnosis. Literature review revealed 13 cases of acute leukemia with bladder involvement. Although leukemic infiltration of the bladder is rare, it should be considered in patients with acute leukemia and hematuria. Urine cytology might help detect bladder involvement.