101
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Atobatele MO, Oyinloye OI, Nasir AA, Bamidele JO. Posterior urethral valve with unilateral vesicoureteral reflux and patent urachus: A rare combination of urinary tract anomaliess. Urol Ann 2015; 7:240-3. [PMID: 25836363 PMCID: PMC4374267 DOI: 10.4103/0974-7796.150496] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 05/29/2013] [Indexed: 11/18/2022] Open
Abstract
Posterior urethral valve (PUV) is a common cause of lower urinary tract obstruction in male infants with an incidence of 1:5000-8000. PUV continues to be a significant cause of morbidity and ongoing renal damage in infants and children. It can coexist with vesicoureteral reflux (VUR) in about 50% of cases and also with patent urachus in about one-third of cases. It is a case of a 22-day-old full-term male child who presented with poor urinary stream and progressive abdominal distension of 5-day duration as well as leakage of clear fluid from umbilicus of 1-day duration. Abdominopelvic ultrasonography showed bilateral hydronephrosis. Micturating cystourethrogram also showed features of bladder outlet obstruction and PUV. In addition, a grade V left VUR and a fistulous tract between the dome of the urinary bladder and the umbilicus, which was consistent with a patent urachus was demonstrated. In conclusion, this case demonstrates a rare combination of congenital urinary tract anomalies involving PUV, left VUR and patent urachus.
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Affiliation(s)
- Mutiu O Atobatele
- Department of Radiology, Paediatric Surgical Unit, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Olalekan I Oyinloye
- Department of Radiology, Paediatric Surgical Unit, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Abdulrasheed A Nasir
- Department of Surgery, Paediatric Surgical Unit, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - John O Bamidele
- Department of Radiology, Paediatric Surgical Unit, University of Ilorin Teaching Hospital, Ilorin, Nigeria
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102
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An unusual long-term survey of a patient with widespread malignant urachal tumor, not given chemotherapy or radiotherapy. Case Rep Radiol 2015; 2015:183787. [PMID: 25838960 PMCID: PMC4369899 DOI: 10.1155/2015/183787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 02/27/2015] [Indexed: 11/17/2022] Open
Abstract
The urachus establishes a connection between the dome of the bladder and the umbilicus throughout fetal life. If the urachus does not close completely, malignancy is a potential complication. The primary treatment for malignant urachal tumor is surgical excision. A 61-year-old male patient diagnosed with urachal carcinoma had undergone partial cystectomy 25 years previously. Twenty years later, local recurrence was treated with another partial cystectomy without umbilical remnant excision. Recurrence at the umbilical site was excised 2 years later, but intraperitoneal invasion had occurred, and the patient underwent a total colectomy at that time. Local disease and disseminated metastases in the thorax and intra- and extraperitoneal areas were noted upon admission to our hospital. Urachal carcinomas are usually aggressive tumors, and surgical treatment should include partial or radical cystectomy and excision of the urachus and umbilicus, to prevent local recurrence and distant metastasis.
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103
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Siow SL, Mahendran HA, Hardin M. Laparoscopic management of symptomatic urachal remnants in adulthood. Asian J Surg 2015; 38:85-90. [DOI: 10.1016/j.asjsur.2014.04.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 02/18/2014] [Accepted: 04/24/2014] [Indexed: 12/26/2022] Open
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104
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da Cruz CLP, Fernandes GL, Natal MRC, Taveira TRT, Bicalho PA, de Brito YQIP. Urachal neoplasia: a case report. Radiol Bras 2015; 47:387-8. [PMID: 25741124 PMCID: PMC4341378 DOI: 10.1590/0100-3984.2013.1879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 01/10/2014] [Indexed: 11/22/2022] Open
Abstract
Diseases of urachal remnants are uncommon and generally located on the junction of the urachal remnant with the bladder dome. In most cases such diseases correspond to mucinous adenocarcinomas and present hematuria as their most common clinical finding. The authors report the case of a 62-year-old female patient undergoing follow-up due to macroscopic hematuria for three years. Ultrasonography and computed tomography findings are described.
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Affiliation(s)
- Célio Lúcio Palha da Cruz
- MDs, Residents of Radiology and Imaging Diagnosis, Hospital de Base do Distrito Federal (HBDF), Brasília, DF, Brazil
| | - Gabriel Lacerda Fernandes
- MDs, Residents of Radiology and Imaging Diagnosis, Hospital de Base do Distrito Federal (HBDF), Brasília, DF, Brazil
| | - Marcelo Ricardo Canuto Natal
- MD, Radiologist, Medical Residency Coordinator (Radiology and Imaging Diagnosis), Hospital de Base do Distrito Federal (HBDF), Radiologist at Diagnóstico das Américas (DASA/Exame-Pasteur), Brasília, DF, Brazil
| | | | - Patrícia Amaral Bicalho
- Medical Practice Resident Physician, Hospital de Base do Distrito Federal (HBDF), Brasília, DF, Brazil
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105
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Trinh TW, Kennedy AM. Fetal Ovarian Cysts: Review of Imaging Spectrum, Differential Diagnosis, Management, and Outcome. Radiographics 2015; 35:621-35. [DOI: 10.1148/rg.352140073] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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106
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Abstract
The urachus is a tubular structure extending from the dome of the bladder to the umbilicus. Normally, this allantoic and cloacal remnant obliterates into a fibrous band by late fetal development. Urachal abnormalities include a patent urachus, urachal cyst, umbilical urachal sinus, and a vesicourachal diverticulum. These abnormalities are most often asymptomatic and only come to clinical attention when associated with infection. A 2-month-old male infant presented to our tertiary pediatric hospital with several days of intermittent fevers and a focal region of swelling and erythema over the umbilicus. On physical examination, a tender mass was palpated in the umbilical region. Ultrasound revealed a long tubular structure coursing from the dome of the bladder anteriorly and superiorly to the subumbilical region. This tubular structure was fluid filled with internal echoes suggestive of infection with abscess formation. The urachal abscess was drained surgically, at which time a patent urachus was also excised. This case demonstrates the importance of having a thorough understanding of urachal anomalies when evaluating infants presenting with umbilical pathology.
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107
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Intestinal obstruction caused by a Meckel’s diverticulum adherent to an infected urachal cyst. ANNALS OF PEDIATRIC SURGERY 2014. [DOI: 10.1097/01.xps.0000452060.45944.c5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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108
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109
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Bo Y. Simple cyst of urinary bladder. Urol Ann 2014; 6:244-6. [PMID: 25125900 PMCID: PMC4127864 DOI: 10.4103/0974-7796.134288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 02/10/2013] [Indexed: 11/29/2022] Open
Abstract
Simple cysts are rare in the urinary bladder and can pose a diagnostic dilemma to both the urologist and the histopathologist. No case study was found in the database of Elsevier Science Direct, Spring-Link, or PubMed. We present two cases of subserous cyst in the bladder and discuss the diagnosis and treatment of the condition. The cystic lesion at bladder dome was detected by radiologic examination and confirmed by cystoscopy. In case 1, transurethral resection was first performed which was followed by partial cystectomy; In case 2, the cyst was removed with the urachus using laparoscopic surgery. The patients recovered uneventfully and the histopathology showed cysts in subserous layer of urinary bladder. The bladder cyst should be distinguished from urachal tumor, and laparoscopic partial cystectomy is the preferred operative procedure.
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Affiliation(s)
- Yang Bo
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China 116027
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110
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Abstract
Urachal inflammation is rarely seen in adults. Two patients with suspected abdominal tumor underwent FDG PET/CT. One patient showed an irregular hypermetabolic mass anterosuperior to the bladder. The other patient showed a thick-walled cystic mass with strong FDG uptake extending from the bladder dome to the anterior abdominal wall. Urachal carcinomas were suspected based on imaging findings. Both patients underwent complete resection of the masses. However, both masses were organized urachal abscesses confirmed by pathological examination. These two cases highlight that differentiation between organized urachal abscess and carcinoma is difficult on the basis of imaging.
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111
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Bannon A, Black P, Turner J, Gray S, Kirk S. Belly button piercings: a saving grace? A patent urachus presenting in a 17-year-old girl. BMJ Case Rep 2014; 2014:bcr-2014-204336. [PMID: 24916980 DOI: 10.1136/bcr-2014-204336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We report the case of a 17-year-old girl who presented to the accident and emergency department with dysuria and foul smelling, bloody discharge from her umbilicus. The definitive diagnosis was that of a patent urachus, which is a fistulous communication between the bladder and the umbilicus, usually diagnosed in early infancy. The incidence of a patent urachus is approximately 1 in 70,000 in the general population. It is highly likely that removal of a recent belly button piercing resulted in the acute presentation by completing the fistulous tract to the skin. This case is of clinical relevance as the diagnosis was missed 18 months prior with a milder presentation. The recommended treatment option is surgical excision due to the potential risk of malignant change, with urachal adenocarcinoma accounting for 0.3% of all bladder cancers.
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Affiliation(s)
- Aidan Bannon
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
| | - Patrick Black
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
| | - Joanna Turner
- Department of Radiology, Ulster Hospital Dundonald, Belfast, UK
| | - Sam Gray
- Department of Urology, Ulster Hospital Dundonald, Belfast, UK
| | - Stephen Kirk
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
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112
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Drejer D, Laursen CB, Graumann O. Dysfunctional bladder catheter: catheter balloon inflated in a small bladder diverticulum. BMJ Case Rep 2014; 2014:bcr-2013-201192. [PMID: 24849629 DOI: 10.1136/bcr-2013-201192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Ditte Drejer
- Urology Department, Fredericia Hospital, Fredericia, Denmark
| | - Christian B Laursen
- Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
| | - Ole Graumann
- Research Unit at the Department of Radiology, Odense University Hospital, Odense, Denmark Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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113
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Bagnara V, Antoci S, Bonforte S, Privitera G, Luca T, Castorina S. Clinical considerations, management and treatment of fever of unknown origin caused by urachal cyst: a case report. J Med Case Rep 2014; 8:106. [PMID: 24661549 PMCID: PMC3978086 DOI: 10.1186/1752-1947-8-106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 02/05/2014] [Indexed: 11/10/2022] Open
Abstract
Introduction Urachal cysts are rare congenital anomalies that often prompt referral to the paediatric general surgeon because of their associated complications such as infection, abdominal pain and the young age at presentation. In this report we describe a rare case of fever of unknown origin caused by an urachal cyst which was successfully treated with incision and drainage only. Since the first description of urachal anomalies by Cabriolus in 1550, few cases have been reported and, until now, only one case of infected urachal cyst presenting as fever of unknown origin has been described in the literature. Moreover, the spontaneous resolution of an urachal cyst without excision is extremely rare. Case presentation We report our experience in the management and treatment of an infected urachal cyst that occurred in a 12-year-old Caucasian girl who presented to our Department of Paediatric Surgery with a 30-day history of evening fever. The urachal cyst was treated only with incision and drainage through a minimally invasive laparoscopic approach. Conclusions The incision and drainage of an infected urachal cyst is a simple and safe procedure. It assures a complete recovery and avoids potential surgical complications related to the total excision of the urachal cyst. This report may provide important clues regarding the management of this rare anomaly and we emphasise the importance for paediatricians, who should consider the possibility that a fever of unknown origin can be caused by an urachal cyst, and for surgeons and urologists, because it suggests that conservative treatment of this rare anomaly should be considered when possible.
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Affiliation(s)
- Vincenzo Bagnara
- Department of Maternal and Infant Medicine and Radiological Sciences, University of Catania, 95123 Catania, Italy.
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114
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Agrawal AK, Bobiński P, Grzebieniak Z, Rudnicki J, Marek G, Kobielak P, Kazanowski M, Agrawal S, Hałoń A. Pseudomyxoma peritonei originating from urachus-case report and review of the literature. ACTA ACUST UNITED AC 2014; 21:e155-65. [PMID: 24523614 DOI: 10.3747/co.21.1695] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pseudomyxoma peritonei (pmp) is a rare clinical condition defined as extensive intraperitoneal spread of mucus associated with a variety of mucinous tumours of varying biologic behavior. Although appendix or ovaries have usually been implicated as the primary site, cases have been reported in association with neoplastic lesions of other sites. Pseudomyxoma peritonei originating from urachal remnants is a unique entity, reported only 18 times in the English literature thus far. Considering the rarity of the lesion, we report the case of a 50-year-old man surgically treated for pmp associated with a low-grade mucinous urachal neoplasm. Unique aspects of case are the low histologic aggressiveness of the causative lesion (reported only twice worldwide) and the early stage of the disease, with a relatively small amount of intraperitoneal free mucin. Review of the literature about pmp in general and a collation of previously reported cases of pmp originating from the urachus are presented and discussed.
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Affiliation(s)
- A K Agrawal
- Second Department of General and Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - P Bobiński
- Department of General Surgery ii , Lower-Silesian Specialised Hospital, Wroclaw, Poland
| | - Z Grzebieniak
- Second Department of General and Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - J Rudnicki
- Wroclaw Medical University, Wroclaw, Poland
| | - G Marek
- Second Department of General and Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - P Kobielak
- Second Department of General and Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - M Kazanowski
- Second Department of General and Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - S Agrawal
- Wroclaw Medical University, Wroclaw, Poland
| | - A Hałoń
- Division of Pathomorphology and Oncological Cytology, Wroclaw Medical University, Wroclaw, Poland
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115
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Huynh K, Krantz J, Ahmadi N, Indrajit B, Khadra M. A case of peritoneal mesothelioma masquerading as a urachal mass. ANZ J Surg 2013; 84:185-6. [PMID: 24165207 DOI: 10.1111/ans.12226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kerrianne Huynh
- Nepean Urological Research Centre, Nepean Hospital, University of Sydney, Kingswood, New South Wales, Australia
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116
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Anand M, Deshmukh SD, Gulati HK, Ladkat SS, Jadhav SE, Purandare SN. Angiomatous leiomyoma of the urachus: A rare entity masquerading as extraluminal gastrointestinal stromal tumor. Urol Ann 2013; 5:200-3. [PMID: 24049386 PMCID: PMC3764904 DOI: 10.4103/0974-7796.115752] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Accepted: 11/18/2011] [Indexed: 11/17/2022] Open
Abstract
The urachus is a vestigial structure located between the dome of the bladder and the umbilicus, which results from the involution of the allantoic duct and the cloaca. Persistence of an embryonic urachal remnant can cause various problems during childhood and young adulthood. Urachal leiomyoma is a rare entity with very few cases being reported in literature. It can be misdiagnosed and confused with a wide spectrum of intra-abdominal or pelvic disorders. We hereby report a case of angiomatous leiomyoma originating from the urachal remnant in a 45-year-old lady, masquerading as extraluminal gastrointestinal stromal tumor. Understanding the embryological basis of these urachal disorders and their imaging features coupled with histopathological examination is crucial for the correct diagnosis and management. Pathological diagnosis is required to optimize the surgical approach and preclude unnecessary radical surgery.
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Affiliation(s)
- Mani Anand
- Department of Pathology, Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune, Maharashtra, India
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117
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Metwalli ZA, Guillerman RP, Mehollin-Ray AR, Schlesinger AE. Imaging features of intravesical urachal cysts in children. Pediatr Radiol 2013; 43:978-82. [PMID: 23370693 DOI: 10.1007/s00247-013-2628-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Revised: 12/14/2012] [Accepted: 12/19/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Urachal cysts, part of the spectrum of congenital urachal anomalies, are typically extrinsic to the urinary bladder. OBJECTIVE The purpose of this study is to present the salient imaging features of a pediatric series of unusual intravesical urachal cysts that protrude into the bladder lumen. MATERIALS AND METHODS Five children with intravesical urachal cysts depicted on imaging studies were retrospectively identified during a 6-year period at a children's hospital. The clinical charts and findings on ultrasound (US) and voiding cystourethrogram (VCUG) were reviewed. RESULTS In all five children, US revealed a thin-walled ovoid cystic structure containing anechoic fluid or echogenic debris and residing along the midline of the anterosuperior aspect of the urinary bladder protruding into the bladder lumen. Histological examination of the partial cystectomy specimen from one child revealed a cystic urachal remnant with intestinal mucosal lining and reactive lymphoid hyperplasia. The cysts in the four other children were managed conservatively without operative intervention. CONCLUSION The purpose of this report is to expand the spectrum of urachal remnant anomalies to include these newly recognized intravesical urachal cysts, which are characterized on US by the presence of a thin-walled cyst along the midline anterosuperior aspect of the urinary bladder.
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Affiliation(s)
- Zeyad A Metwalli
- Department of Radiology, Baylor College of Medicine, Houston, TX 77030, USA.
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118
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Abstract
Urachal cancer is a rare pathology (less than 1% among all bladder tumors) with a poor prognosis for all stages, because of clinical delay leading to a late diagnosis, difficult differential diagnosis with bladder cancer, and no consensus for the treatment, mostly about the chemotherapy for advanced stages, because there are no data from prospective studies. A surgical treatment can be performed for the localized stages, but there are no real guidelines for local relapses and metastatic progression treatment. Those cancers are not radio- or chemosensitive; nevertheless data from fundamental research are missing. As this pathology is really uncommon, there are no clinical studies with targeted therapies. The purpose of this review is to introduce the most important clinical and paraclinical features of those cancers, and the usual treatment performed.
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119
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Hesse N, Füllhase C, Wengenroth M. Raumforderung im Unterbauch mit verzogenem Harnblasendach. Radiologe 2013; 53:434-6. [DOI: 10.1007/s00117-013-2502-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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120
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Meeks JJ, Herr HW, Bernstein M, Al-Ahmadie HA, Dalbagni G. Preoperative Accuracy of Diagnostic Evaluation of the Urachal Mass. J Urol 2013; 189:1260-2. [DOI: 10.1016/j.juro.2012.10.043] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 10/12/2012] [Indexed: 10/27/2022]
Affiliation(s)
- Joshua J. Meeks
- Urology Service, Department of Surgery and Department of Pathology (HAAA), Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Harry W. Herr
- Urology Service, Department of Surgery and Department of Pathology (HAAA), Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Melanie Bernstein
- Urology Service, Department of Surgery and Department of Pathology (HAAA), Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Hikmat A. Al-Ahmadie
- Urology Service, Department of Surgery and Department of Pathology (HAAA), Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Guido Dalbagni
- Urology Service, Department of Surgery and Department of Pathology (HAAA), Memorial Sloan-Kettering Cancer Center, New York, New York
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121
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A rare cause of urachal adenocarcinoma: urachal diverticle. Case Rep Urol 2013; 2013:571395. [PMID: 23476880 PMCID: PMC3580940 DOI: 10.1155/2013/571395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 01/04/2013] [Indexed: 11/17/2022] Open
Abstract
Urachus is the remnant of the embryologic allantois and the fetal bladder, extending form the bladder roof to the umbilicus. It degenerates in the prenatal period into a tissue band known as the median umbilical ligament. Incomplete degeneration may lead to urachal diverticle development. It is difficult to diagnose unless it is considered in differential diagnosis and imaging modalities are employed. This paper describes a patient treated with partial cystectomy for urachal diverticle, and the pathologic examination revealed urachal adenocarcinoma.
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122
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Abstract
Urachal cysts present very uncommonly in adults. We describe a 25-year-old man who attended with a discharging umbilical swelling and pain. Ultrasonography and CT scan demonstrated an infected urachal cyst which, following cystoscopy, was excised without complication.
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Affiliation(s)
- Bhavna L Gami
- Department of Biosurgery and Surgical Technology, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK.
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123
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Willson TD, Revesz E, Podbielski FJ, Connolly MM. Unusual Findings in a Benign Urachal Tumor. Am Surg 2013. [DOI: 10.1177/000313481307900211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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124
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Kini V, Esmail KZA, Abdelhamid Ibrahim A. Acute presentation of Urachal remnant. Qatar Med J 2012; 2012:79-80. [PMID: 25003046 PMCID: PMC3991047 DOI: 10.5339/qmj.2012.2.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Accepted: 12/01/2012] [Indexed: 11/11/2022] Open
Affiliation(s)
- V Kini
- Hamad Medical Corporation, Doha, Qatar
- Address for Correspondence: V Kini E-mail:
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125
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Genitourinary imaging: part 1, congenital urinary anomalies and their management. AJR Am J Roentgenol 2012; 199:W545-53. [PMID: 23096198 DOI: 10.2214/ajr.11.8197] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Congenital urinary anomalies may be symptomatic or encountered during imaging for other clinical indications. The array of abnormalities is related to the embryologic stage at the time of the developmental insult, and these abnormalities result in a spectrum of conditions ranging from insignificant to incompatible with life. CONCLUSION Understanding the implications of common congenital urinary anomalies is the key to detecting associated anomalies, initiating therapy, and avoiding both complications and unnecessary intervention.
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126
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Lee RKL, Cho CCM, Tong CSL, Ng AWH, Liu EKW, Griffith JF. Ultrasound of the abdominal wall and groin. Can Assoc Radiol J 2012; 64:295-305. [PMID: 23103240 DOI: 10.1016/j.carj.2012.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 06/27/2012] [Accepted: 07/06/2012] [Indexed: 10/27/2022] Open
Affiliation(s)
- Ryan K L Lee
- Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, People's Republic of China.
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127
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Tazi F, Ahsaini M, Khalouk A, Mellas S, Stuurman-Wieringa RE, Elfassi MJ, Farih MH. Abscess of urachal remnants presenting with acute abdomen: a case series. J Med Case Rep 2012; 6:226. [PMID: 22846644 PMCID: PMC3459711 DOI: 10.1186/1752-1947-6-226] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 05/22/2012] [Indexed: 11/20/2022] Open
Abstract
Introduction Urachal diseases are rare and may develop from a congenital anomaly in which a persistent or partial reopening of the fetal communication between the bladder and the umbilicus persists. The most frequently reported urachal anomalies in adults are infected urachal cyst and urachal carcinoma. The diagnosis of this entity is not always easy because of the rarity of these diseases and the atypical symptoms at presentation. Imaging techniques, such as ultrasonography and computed tomography have a significant role in recognizing the presence of urachus-derived lesions. Cases presentations Case presentation 1: A 25-year-old Arab-Berber man presented with a 10-day history of progressive lower abdominal pain accompanied by fever, vomiting, and low urinary tract symptoms to our emergency department. Laboratory data revealed leucocytosis. The diagnosis of an acute peritonitis was made initially. Abdominal ultrasonography revealed a hypoechoic tract from the umbilicus to the abdominal wall, and the diagnosis was rectified (infected urachal remnants). The patient was initially treated with intravenous antibiotics in combination with a percutaneous drainage. Afterwards an extraperitoneal excision of the urachal remnant including a cuff of bladder was performed. The histological analysis did not reveal a tumor of the urachal remnant. Follow-up examinations a few months later showed no abnormality. Case presentation 2: A 35-year-old Arab-Berber man, without prior medical history with one week of abdominal pain, nausea and vomiting, associated with fever but without lower urinary tract symptoms visited our emergency department. Laboratory data revealed leucocytosis. Abdominal ultrasonography was not conclusive. Computed tomography of the abdomen was the key to the investigation and the diagnosis of an abscess of urachal remnants was made. The patient underwent the same choice of medical-surgical treatment as previously described for case one, with a good follow-up result. Case presentation 3: A 22-year-old Arab-Berber man, with no relevant past medical history, presented to our emergency department because of suspected acute surgical abdomen. Physical examination revealed umbilical discharge with erythema and a tender umbilical mass. Abdominal ultrasonography and computed tomography scan confirmed the diagnosis of infected urachal sinus. Initial management was intravenous antibiotics associated with a percutaneous drainage with a good post-operative result, but a few days later, he was readmitted with the same complaint and the decision was made for surgical treatment consisting of excision of the infected urachal sinus. The clinical course was uneventful. Histological examination did not reveal any signs of malignancy. Conclusions We describe our clinical observations and an analysis of the existing literature to present the various clinical, radiological, pathological and therapeutic aspects of an abscess of urachal remnants. To the best of our knowledge, this manuscript is an original case report because this atypical presentation is rarely reported in the literature and only a few cases have been described.
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Affiliation(s)
- Fadl Tazi
- Department of Urology, Hospital University Center Hassan II, Fez, 30000 Morocco.
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Chamié LP, Blasbalg R, Pereira RMA, Warmbrand G, Serafini PC. Findings of pelvic endometriosis at transvaginal US, MR imaging, and laparoscopy. Radiographics 2012; 31:E77-100. [PMID: 21768230 DOI: 10.1148/rg.314105193] [Citation(s) in RCA: 141] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Endometriosis is a common multifocal gynecologic disease that manifests during the reproductive years, often causing chronic pelvic pain and infertility. It may occur as invasive peritoneal fibrotic nodules and adhesions or as ovarian cysts with hemorrhagic content. Although findings at physical examination may be suggestive, imaging is necessary for definitive diagnosis, patient counseling, and treatment planning. The imaging techniques that are most useful for preoperative disease mapping are transvaginal ultrasonography (US) after bowel preparation, and magnetic resonance (MR) imaging. Initial transvaginal US is a reliable technique for detecting rectosigmoid endometriotic lesions. MR imaging is indicated as a complementary examination in complex cases of endometriosis with extensive adhesions and ureteral involvement. Peritoneal endometriotic implants are typically hypoechoic on transvaginal US images and demonstrate low signal intensity on T2-weighted MR images. Endometriotic implants most commonly are found in retrocervical and rectosigmoid sites, followed by the vagina, bladder, and ureters. Cysts with low-level internal echoes and echogenic peripheral foci at transvaginal US are suggestive of endometriomas. MR imaging has high specificity for identifying endometriomas, which are characterized by high signal intensity on T1-weighted images and low signal intensity on T2-weighted images. Correlation of the radiologic imaging features of endometriotic lesions with their laparoscopic appearances may help improve individual proficiency in the radiologic diagnosis of endometriosis.
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129
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Monteiro V, Cunha TM. Urachal carcinoma: imaging findings. Acta Radiol Short Rep 2012; 1:10.1258_arsr.2011.110018. [PMID: 23986824 PMCID: PMC3738333 DOI: 10.1258/arsr.2011.110018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 12/06/2011] [Indexed: 11/18/2022] Open
Abstract
Urachal carcinoma is a rare neoplasm, which accounts for only 0.5-2% of bladder malignancies, and arises from a remnant of the fetal genitourinary tract. A 46-year-old woman presented with a history of pelvic pain and frequent daytime urination. Ultrasound (US), computed tomography (CT), and magnetic resonance (MR) demonstrated a supravesical heterogeneous mass with calcifications. The patient underwent a partial cystectomy with en-bloc resection of the mass and histopathological examination revealed the diagnosis of urachal adenocarcinoma. Urachal carcinomas are usually associated with poor prognosis and early diagnosis is fundamental. CT and MR are useful to correctly diagnose and preoperatively staging.
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Nakazato T, Suzuki K, Mihara A, Sanada Y, Aisa Y, Kakimoto T, Moriyama M. Urachal remnant infection leading to Pseudomonas aeruginosa bacteremia in induction therapy for adult B-cell acute lymphoblastic leukemia. Int J Hematol 2011; 94:298-299. [PMID: 21858444 DOI: 10.1007/s12185-011-0911-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 07/29/2011] [Accepted: 08/01/2011] [Indexed: 10/17/2022]
Affiliation(s)
- Tomonori Nakazato
- Division of Hematology, Department of Internal Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawacho, Hodogaya-ku, Yokohama, 160-8582, Japan.
| | - Kazuhito Suzuki
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ai Mihara
- Division of Hematology, Department of Internal Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawacho, Hodogaya-ku, Yokohama, 160-8582, Japan
| | - Yukinari Sanada
- Division of Hematology, Department of Internal Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawacho, Hodogaya-ku, Yokohama, 160-8582, Japan
| | - Yoshinobu Aisa
- Division of Hematology, Department of Internal Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawacho, Hodogaya-ku, Yokohama, 160-8582, Japan
| | | | - Masatoshi Moriyama
- Department of Urology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
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Tan CH, Vikram R, Boonsirikamchai P, Faria SC, Charnsangavej C, Bhosale PR. Pathways of extrapelvic spread of pelvic disease: imaging findings. Radiographics 2011; 31:117-33. [PMID: 21257938 DOI: 10.1148/rg.311105050] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complex extraperitoneal anatomy of the pelvis includes various outlets for the transit of organs and neurovascular structures to the rest of the body. These outlets include the greater sciatic foramen, lesser sciatic foramen, inguinal canal, femoral triangle, obturator canal, anal and genitourinary hiatuses of the pelvic floor, prevesical space, and iliopsoas compartment. All of these structures serve as conduits for the dissemination of malignant and benign inflammatory diseases from the pelvic cavity and into the soft-tissue structures of the abdominal wall, buttocks, and upper thigh. Knowledge of the pelvic anatomy is crucial to understand these patterns of disease spread. Cross-sectional imaging provides important anatomic information and depicts the extent of disease and its involvement of surrounding extrapelvic structures, information that is important for planning surgery and radiation therapy.
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Affiliation(s)
- Cher Heng Tan
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas M. D. Anderson Cancer Center, Houston, Tex., USA.
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Richard R, Bouanane M, Salomon L, Vordos D, Pigneur F, Werbrouck A, Rahmouni A, Luciani A. [Urachus pathology: infected urachal cyst]. ACTA ACUST UNITED AC 2011; 92:250-3. [PMID: 21501765 DOI: 10.1016/j.jradio.2011.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2010] [Revised: 02/14/2011] [Accepted: 02/15/2011] [Indexed: 11/16/2022]
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Chamié LP, Pereira RMA, Zanatta A, Serafini PC. Transvaginal US after bowel preparation for deeply infiltrating endometriosis: protocol, imaging appearances, and laparoscopic correlation. Radiographics 2011; 30:1235-49. [PMID: 20833848 DOI: 10.1148/rg.305095221] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Deeply infiltrating endometriosis (DIE) is a common gynecologic disease that is characterized by a difficult and delayed diagnosis. Radiologic mapping of the DIE lesion sites is crucial for case management, patient counseling, and surgical planning. Transvaginal ultrasonography (US) is the initial imaging modality for investigating DIE and has been the focus of several recent studies. DIE typically manifests at imaging as hypoechogenic nodules throughout the affected sites and thickening of the intestinal wall, with some lesions showing a mixed pattern due to cystic areas. Transvaginal US performed after bowel preparation improves the ability to diagnose intestinal lesions and provides invaluable details, including which layers of the intestine are affected and the distance between the lesion and the anal border. It is vital that radiologists be familiar with the technical aspects of this modality and with the US manifestations of DIE lesions. Transvaginal US performed after bowel preparation should be the first-line imaging modality for the evaluation of women with suspected endometriosis.
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Affiliation(s)
- Luciana Pardini Chamié
- Department of Diagnostic Imaging, Fleury Medicina e Saúde, Rua Cincinato Braga, São Paulo, Brazil.
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135
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Chouhan M, Cuckow P, Humphries PD. Utility of diffusion-weighted imaging in the presurgical diagnosis of an infected urachal cyst. Pediatr Radiol 2011; 41:125-8. [PMID: 20711571 DOI: 10.1007/s00247-010-1792-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Revised: 05/20/2010] [Accepted: 06/21/2010] [Indexed: 10/19/2022]
Abstract
Urachal cysts are one of a spectrum of urachal abnormalities that occur following failure of regression of the allantois and presumptive bladder between 4 weeks and 6 weeks of gestation. Infection is the most common complication of this rare congenital anomaly. The nonspecific presentation may mimic other pathological processes, underlining their clinical and radiological significance. Imaging investigations typically include US and CT, both of which are limited in their ability to characterize lesions. We report the case of a 5-year-old presenting with macroscopic haematuria in whom diffusion-weighted MRI (DWI) suggested the diagnosis of an infected urachal cyst, which was confirmed surgically. We discuss the radiological findings in multiple imaging modalities and present the application of DWI in this context as a means of improving the radiological diagnostic yield.
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Affiliation(s)
- Manil Chouhan
- Department of Radiology, University College London Hospital, London, UK
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136
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Abstract
Urachal cyst complications requiring surgical intervention are rarely seen in adults, because the urachus is normally obliterated in infancy. Necrotizing fasciitis due to an infected urachal cyst in an adult female has not been reported. We describe the case of a fifty-year-old female who required aggressive surgical management of abdominal wall necrotizing soft tissue infection from an infected urachal cyst.
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137
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Schaefer IM, Männer J, Faber R, Loertzer H, Füzesi L, Seeliger S. Giant umbilical cord edema caused by retrograde micturition through an open patent urachus. Pediatr Dev Pathol 2010; 13:404-7. [PMID: 20085482 DOI: 10.2350/09-10-0731-cr.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A giant umbilical cord is a rare finding in mature newborns and originates from different developmental etiologies. We report on a case of a mature female newborn presenting a 50 × 8-cm giant umbilical cord without further malformations. Antenatal sonographic findings of a diffuse giant umbilical cord, elevated creatinine levels of 1.3 mg/dL in umbilical cord edema, gross and histopathological findings of allantoic remnants, and umbilical urinary discharge lead to the diagnosis of a patent urachus with retrograde micturition into the umbilical cord. Postnatal surgical repair was required. In antenatal sonography, cystic and diffuse changes should be considered in the differential diagnosis of a giant umbilical cord. In cases of diffuse enlargement, elevated umbilical creatinine can support the diagnosis of a patent urachus with open leakage into the Wharton's jelly. Appropriate surgical management is required.
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Affiliation(s)
- Inga-Marie Schaefer
- Department of Gastroenteropathology, University Medicine Göttingen, Robert-Koch-Straße 40, Göttingen, Germany.
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138
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Ha YS, Kim YW, Min BD, Lee OJ, Kim YJ, Yun SJ, Lee SC, Kim WJ. Alpha-methylacyl-coenzyme a racemase-expressing urachal adenocarcinoma of the abdominal wall. Korean J Urol 2010; 51:498-500. [PMID: 20664785 PMCID: PMC2907501 DOI: 10.4111/kju.2010.51.7.498] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Accepted: 04/12/2010] [Indexed: 11/18/2022] Open
Abstract
Urachal adenocarcinomas are very rare and about one third of these neoplasms arise in urachal remnants. To demonstrate the origin of the urachal adenocarcinoma is not easy, but it is very important for managing patient care. We report on a 35-year-old man who complained of a palpable mass in the periumbilical area. The mass was incidentally identified 10 days earlier. Computed tomography revealed a well-defined enhancing mass with internal calcification and septation abutting on the dome of the urinary bladder. The clinical diagnosis was urachal cancer, which seemed to invade the urinary bladder. Thus, we performed mass excision and partial resection of the bladder. Histopathologically, the mass was diagnosed as mucinous cystadenocarcinoma originating from urachal remnants that showed an unusual expression of alpha-methylacyl-coenzyme A racemase (AMACR). To our knowledge, this report is the first case of AMACR-expressing urachal adenocarcinoma arising in the abdominal wall.
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Affiliation(s)
- Yun-Sok Ha
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea
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139
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Widni EE, Höllwarth ME, Haxhija EQ. The impact of preoperative ultrasound on correct diagnosis of urachal remnants in children. J Pediatr Surg 2010; 45:1433-7. [PMID: 20638520 DOI: 10.1016/j.jpedsurg.2010.01.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Revised: 12/23/2009] [Accepted: 01/02/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Ultrasound is a noninvasive imaging method used widely in urachal diagnostics. This study investigated the effectiveness of ultrasonography in correctly depicting urachal anomalies in children. METHODS Preoperative ultrasound findings of all patients who were operated on for suspected urachal anomalies between 1990 and 2008 were retrospectively compared with the final diagnosis. RESULTS Fifty-three patients (31 female, 22 male; approximately 2.6 years; range, 0-17 years) were reviewed. In 37 patients, the final diagnosis of an urachal anomaly matched the ultrasound findings. In 7 patients, there was a false-positive ultrasound finding, and in 9 patients, there was a false-negative ultrasound finding. Three of 4 patients with urachal cysts, 23 of 29 patients with urachal fistulas, and 8 of 10 patients with urachal sinuses were correctly identified by ultrasonography. In 10 patients, no urachal rests were found intraoperatively: in 7 of these patients, urachal rests were falsely suspected by ultrasound. The positive predictive value for ultrasound is 83%, whereas the negative predictive value is 25%. The sensitivity for this diagnostic method is 79% and the specificity 30%. CONCLUSIONS Ultrasound helps to identify urachal anomalies in case of their presence but is not helpful to rule out a nonexisting urachal anomaly.
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Affiliation(s)
- Eva E Widni
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, 3036 Graz, Austria
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140
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Affiliation(s)
- Svati Singla Long
- Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland, USA
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141
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Sepulveda W, Rompel SM, Cafici D, Carstens E, Dezerega V. Megacystis associated with an umbilical cord cyst: a sonographic feature of a patent urachus in the first trimester. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:295-300. [PMID: 20103802 DOI: 10.7863/jum.2010.29.2.295] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The purpose of this series was to report the first-trimester sonographic findings, antenatal course, and outcome in fetuses with a patent urachus. METHODS We conducted a review of ultrasound reports and medical charts from 3 pregnancies complicated by a congenital patent urachus detected in the first trimester. RESULTS All 3 fetuses had megacystis and an umbilical cord cyst close to the fetal abdominal insertion that was detected in the first trimester. In 2 cases, the megacystis resolved spontaneously while the umbilical cord cyst worsened in appearance; among them, massive edema of the umbilical cord was documented in 1, and evidence of partial bladder exstrophy was detected in the third trimester in the other. Both cases required neonatal surgery with no complications. In the remaining case, the fetus died in the early second trimester. Postmortem examination confirmed the diagnosis of a patent urachus, an allantoic cyst, and thrombosis of the umbilical vessels. CONCLUSIONS Megacystis is a warning sign of a patent urachus in the first trimester. The prognosis of this condition is generally good; however, fetal death can occur secondary to compression of umbilical vessels due to the expanding allantoic cyst.
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142
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Transitional cell carcinoma in urachal cyst. ACTA ACUST UNITED AC 2009; 35:764-6. [DOI: 10.1007/s00261-009-9576-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Accepted: 08/31/2009] [Indexed: 11/27/2022]
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143
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Koster IM, Cleyndert P, Giard RWM. Best cases from the AFIP: urachal carcinoma. Radiographics 2009; 29:939-42. [PMID: 19448126 DOI: 10.1148/rg.293085152] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Ingrid M Koster
- Department of Radiology, Maasstad Ziekenhuis, Olympiaweg 350, 3078 HT Rotterdam, the Netherlands.
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144
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Renard O, Robert G, Guillot P, Pasticier G, Roche JB, Bernhard JC, Azizi A, Ferrière JM, Wallerand H. Pathologies bénignes de l’ouraque chez l’adulte : origine embryologique, présentation clinique et traitements. Prog Urol 2008; 18:634-41. [DOI: 10.1016/j.purol.2008.04.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2008] [Revised: 03/20/2008] [Accepted: 04/30/2008] [Indexed: 10/21/2022]
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145
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Lee GY, Lee SW, Choi KJ, Hwang JY. An infected urachal cyst containing an appendicolith: a case report. Clin Imaging 2008; 32:480-2. [PMID: 19006779 DOI: 10.1016/j.clinimag.2007.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Accepted: 12/17/2007] [Indexed: 11/17/2022]
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Maletic V, Cerovic S, Lazic M, Stojanovic M, Stevanovic P. Synchronous and multiple transitional cell carcinoma of the bladder and urachal cyst. Int J Urol 2008; 15:554-6. [DOI: 10.1111/j.1442-2042.2008.02026.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Meckel's diverticulum is the most common congenital gastrointestinal anomaly, and 2-4% of patients with a Meckel's diverticulum will subsequently develop complications, including intestinal hemorrhage, intestinal obstruction, and diverticulitis. Meckel's diverticulitis is infrequently included in the differential diagnosis of abdominal pain in older adults. We present a case of Meckel's diverticulitis in a 74 year-old male who presented with non-specific abdominal pain and angina. Here, multi-detector computed tomography (MD-CT) imaging provided a pre-operative diagnosis of Meckel's diverticulitis. We then offer a review of the epidemiology, anatomy, radiologic findings, and differential diagnosis of Meckel's diverticulitis. This case presents coronal and sagittal MD-CT reconstructions of Meckel's diverticulitis that have yet to be well-described in the literature.
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149
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Depree PJ, Wong CKF. Patent urachus in a neonate: findings at micturating cystourethregram. AUSTRALASIAN RADIOLOGY 2007; 51 Suppl:B224-B226. [PMID: 17991070 DOI: 10.1111/j.1440-1673.2007.01777.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
A term female infant with an antenatal diagnosis of a urachal anomaly presented at 5 days of age for elective surgical repair of the anomaly. She had been passing urine via the umbilicus since birth. No other abnormalities had been detected on clinical examination. Preoperative micturating cystourethregram (MCUG) was performed, and during catheterization of the bladder per urethra, the catheter tip passed into the bladder and out of the umbilicus, thus confirming the diagnosis of a patent urachus.
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Affiliation(s)
- P J Depree
- Department of Radiology, The Children's Hospital at Westmead, Westmead NSW, Sydney, Australia.
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Fernández EMLT, Siverio NH, Almaraz RL, Viota LM, Luis JR, Flores LD. Radical surgery and IVA-chemotherapeutic regimen to treat embryonal rhabdomyosarcoma of the urachus: case report. Pediatr Hematol Oncol 2007; 24:543-50. [PMID: 17786791 DOI: 10.1080/08880010701533678] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although rhabdomyosarcoma is the most frequent soft tissue tumor in children, there are extremely few reports of this tumor arising from the urachus. The authors describe another case in a 6-year-old female associated with constipation and a painless suprapubic mass. The specimen had the pathological criteria used to define urachal sarcoma (cytological, histological, and immunohistochemical findings) and urachal remnants were not observed. After complete resection of the primary tumor the patient was treated with chemotherapy (ifosfamide, vincristine, and dactinomycin) and remains alive at 4 years' follow-up with no signs of recurrence. Nowadays the management of children with urachal rhabdomyosarcoma usually includes surgery and chemotherapy. Multimodal therapy and surgery are constantly evolving and have significantly improved overall survival of these patients especially in R0 resected patients.
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