Gross Hematuria and Focal Renal Masses as Initial Features of a Mature B-cell Leukemia in an Adolescent Male

We report a case of a 14-year-old boy who presented with gross hematuria and focal bilateral renal masses as presenting features of a mature high-grade B-cell leukemia, Burkitt subtype. The patient was treated with standard chemotherapy with the addition of rituximab and has no evidence of disease on completion. To our knowledge, this is the first case to describe gross hematuria in conjunction with focal bilateral renal masses as presenting features in a pediatric patient with Burkitt leukemia. This unique presentation suggests that early leukemic infiltration of the urinary collecting system may occur but is extremely unusual.