Diagnosis of leukemic relapse in the pelvic soft tissues of juvenile females.

Five females with childhood acute lymphocytic leukemia whose disease relapsed in the pelvis were studied. In all five patients, relapse occurred late in the disease process, and all patients had been in complete continuous remission before relapse. Intravenous pyelogram and barium enema revealed hydronephrosis or a mass effect on the bladder or rectosigmoid colon. In three patients, sonography established the presence of a clinically palpable mass with involvement of the uterus, ovaries, and pelvic side walls. In one patient there was infiltration of the bladder and in another, infiltration of the appendix, both confirmed by biopsy.