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Pradeep I, Kumar N, Kalyani P, Nigam JS, Somalwar SB, Srirambhatla A, Rath A. Urorectal Septum Malformation Sequence With Retroperitoneal Neuroblastoma: A Case Report of an Unusual Association. Pediatr Dev Pathol 2024; 27:77-82. [PMID: 37771145 DOI: 10.1177/10935266231196032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Urorectal septum malformation sequence (URSMS) is an uncommon disease characterized by a failure of the anorectal septum to divide the cloaca and fuse with the cloacal membrane. Complete URSMS is usually lethal in newborn due to severe renal dysfunction and pulmonary hypoplasia. Partial URSMS is compatible with life with a single perineal opening draining a common cloaca with an imperforate anus which amenable to surgical management. Antenatal diagnosis of URSMS is challenging because of multisystem, complex abnormalities involving gastrointestinal, urogenital tract, cardiovascular, and musculoskeletal systems. In this case report, we describe a 15-week male fetus with partial URSMS having a spectrum of multisystem structural anomalies associated with fetal neuroblastoma in retroperitoneal location and adrenal neuroblastoma in situ.
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Affiliation(s)
- Immanuel Pradeep
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Naina Kumar
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Poojitha Kalyani
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Jitendra Singh Nigam
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Shrinivas Bheemrao Somalwar
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Annapurna Srirambhatla
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Ashutosh Rath
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
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Yahya MH. Bladder Agenesis: A Systematic Review. Cureus 2023; 15:e45121. [PMID: 37842406 PMCID: PMC10569670 DOI: 10.7759/cureus.45121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2023] [Indexed: 10/17/2023] Open
Abstract
Bladder agenesis is a rare congenital deformity characterized by the absence of the bladder. It is primarily observed in postmortem dissections of stillbirths rather than live births. The condition is often associated with other congenital anomalies, leading to the hypothesis that most affected fetuses do not survive to term. However, the exact cause and specific associated anomalies remain unclear and poorly described in the literature. The limited mention of bladder agenesis in textbooks and literature underscores the importance of creating a comprehensive source for future research in this field. Therefore, our objective is to collect and analyze data on bladder agenesis, focusing on associated anomalies and potential causes, to enhance our understanding of the condition. We conducted a thorough review of reports collected from three databases, Google Scholar, PubMed, and Science Direct, last searched on July 30, 2023, starting with 327 reports. Excluding duplicates and records written in languages other than English, veterinary studies, irrelevant reports, or stillbirths. Inclusion criteria were the following: cases must have proven bladder agenesis, not hypoplasia, and must have most of the information, including the age of diagnosis, presenting symptoms, gender, associated anomalies, and management or outcome of the patient. A quality assessment was conducted according to the Joanna Briggs Institute checklist for case reports. A total of 65 case reports from 56 articles were included in the review. Through our manual analysis, we documented a wild array of malformations associated with bladder agenesis. Among the reports reviewed, 93% exhibited urinary system malformations beside bladder agenesis, 77% were found to have reproductive malformations, 44% had gastrointestinal anomalies, 38% showed musculoskeletal malformations, 28% had cardiac malformations, and another 28% had vascular anomalies. The overall mortality rate was 38%, with a higher rate of 74% for males compared to 20% for females. By collating and analyzing those case reports, we aim to contribute to a better understanding of bladder agenesis and its associated anomalies, facilitating further investigations and advancements in the field.
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Kusaka H, Sugiyama M, Kameshima S, Kakizaki T, Suzuki Y, Ando R, Miura H, Kikuchi M, Kawaguchi H, Sakaguchi M. Male pseudohermaphroditism in a complex malformed calf born with an acardius amorphus cotwin-a case report. BMC Vet Res 2023; 19:86. [PMID: 37464343 DOI: 10.1186/s12917-023-03639-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 06/28/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Male pseudohermaphroditism is a developmental anomaly wherein animals are genetically and gonadally male, but their internal and/or external genitalia resemble those of females. In cattle, pseudohermaphroditism is often accompanied by multiple severe malformations. To the best of our knowledge, this is the first report of male pseudohermaphroditism in a complex malformed calf born with an acardius amorphous cotwin. CASE PRESENTATION This report describes the case of a three-day-old, male anurous Japanese Black calf born with an acardius amorphous cotwin, complete absence of the tail, agenesis of the anus, separate scrota, and umbilical hernia. Transthoracic echocardiography and computed tomography revealed serious malformations in the skeletal system and the circulatory, digestive, urinary, and genital organs. Necropsy revealed rectal atresia, immature testes, epididymis, and penis, but no male accessory gonads. Histological analyses revealed vaginal- and uterine-like tissues adjacent to or fused to the rectum. Fluorescence in situ hybridization detected X and Y chromosomes, and some cells presented two X-probe signals in the same nucleus. CONCLUSIONS In contrast to the male genitalia, the female genitalia derived from the Müllerian ducts were difficult to detect by necropsy in the presented case. Many similar cases may be overlooked in clinical practice.
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Affiliation(s)
- Hiromi Kusaka
- Laboratory of Theriogenology, School of Veterinary Medicine, Kitasato University, Towada, Aomori, 034-8628, Japan
| | - Makoto Sugiyama
- Laboratory of Veterinary Anatomy, School of Veterinary Medicine, Kitasato University, Towada, Aomori, 034-8628, Japan
| | - Satoshi Kameshima
- Laboratory of Small Animal Internal Medicine, School of Veterinary Medicine, Kitasato University, Towada, Aomori, 034-8628, Japan
| | - Takehiko Kakizaki
- Laboratory of Veterinary Radiology and Radiation Biology, School of Veterinary Medicine, Kitasato University, Towada, Aomori, 034-8628, Japan
| | - Yasunori Suzuki
- Laboratory of Animal Hygiene, School of Veterinary Medicine, Kitasato University, Towada, Aomori, 034-8628, Japan
| | - Ryo Ando
- Laboratory of Veterinary Pathology, School of Veterinary Medicine, Kitasato University, Towada, Aomori, 034-8628, Japan
| | - Hiroshi Miura
- Laboratory of Theriogenology, School of Veterinary Medicine, Kitasato University, Towada, Aomori, 034-8628, Japan
| | - Motohiro Kikuchi
- Veterinary Clinical Education Promotion Office, School of Veterinary Medicine, Kitasato University, Towada, Aomori, 034-8628, Japan
| | - Hiroaki Kawaguchi
- Laboratory of Veterinary Pathology, School of Veterinary Medicine, Kitasato University, Towada, Aomori, 034-8628, Japan.
| | - Minoru Sakaguchi
- Laboratory of Theriogenology, School of Veterinary Medicine, Kitasato University, Towada, Aomori, 034-8628, Japan.
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Nayak SS, Harkness R, Shukla A, Banka S, Newman WG, Girisha KM. Clinically diverse and perinatally lethal syndromes with urorectal septum malformation sequence. Am J Med Genet A 2023; 191:730-741. [PMID: 36478354 PMCID: PMC7615864 DOI: 10.1002/ajmg.a.63067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/17/2022] [Accepted: 11/20/2022] [Indexed: 12/12/2022]
Abstract
Urorectal septum malformation sequence (URSMS) is characterized by a spectrum of anomalies of the urogenital system, hindgut and perineum. It is presumed to be a constellation of an embryonic defect. Herein, we analyzed the clinically diverse syndromes associated with URSMS in our perinatal evaluation unit. We reviewed fetuses with URSMS in referrals for perinatal autopsy over a period of 3 years. Chromosomal microarray and genome sequencing were performed whenever feasible. Literature was reviewed for syndromes or malformations with URSMS. We ascertained URSMS in 12 of the 215 (5%) fetuses. Nine fetuses (75%) had complete URSMS and remainder had partial/intermediate URSMS. Eleven fetuses had malformations of other systems that included: cerebral ventriculomegaly; right aortic arch with double outlet right ventricle; microcephaly with fetal akinesia deformation sequence; ventricular septal defect and radial ray anomaly; thoraco-abdominoschisis and limb defects; myelomeningocele; spina bifida and fused iliac bones; omphalocele; occipital encephalocele; lower limb amelia and cleft foot. We report on six fetuses with recurrent and five fetuses with unique malformations/patterns where URSMS is a component. Exome sequencing (one family) and genome sequencing (eight families) were performed and were nondiagnostic. Additionally, we review the literature for genetic basis of this condition. URMS is a clinically heterogeneous condition and is a component of several multiple malformation syndromes. We describe several unique and recurrent malformations associated with URSMS.
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Affiliation(s)
- Shalini S. Nayak
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Robert Harkness
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UK
- Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Anju Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Siddharth Banka
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UK
- Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - William G. Newman
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UK
- Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Katta M. Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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Ganesan N, Gurusamy U, Venkataswamy C, Sankar K. A Spectrum of Congenital Anomalies of the Kidney and Urinary Tract (CAKUT)-Diagnostic Utility of Perinatal Autopsy. Indian J Pediatr 2023; 90:139-145. [PMID: 35980547 DOI: 10.1007/s12098-022-04305-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/07/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To describe the spectrum of congenital renal anomalies and emphasize the critical role of comprehensive autopsy examination in identifying CAKUT, especially of lower urinary tract malformations correlating with prenatal imaging methods. METHODS Retrospective analyses of CAKUT diagnosed at fetal autopsy were analyzed over a 7-y period and correlated with prenatal imaging findings. RESULT Among the 255 fetal autopsies, 45 cases were detected with CAKUT. Isolated (27%), syndromic CAKUT (51%), and CAKUT associated with other system anomalies (22%) were found. Hydronephrosis, followed by cystic renal diseases and agenesis were the common renal malformations. The gastrointestinal tract (GIT) was the commonest system associated with CAKUT. Among the syndromic CAKUT, the urorectal septum malformation (URSM) was the most frequent one, followed by VACTER-L, acrorenal syndrome, and OEIS complex. When correlating prenatal USG and autopsy findings, a significant change in final diagnosis was observed in 60% of cases. CONCLUSION Extrarenal malformations and syndromic associations of CAKUT predominated over isolated ones. Detection of lower urinary tract anomalies in CAKUT is difficult through antenatal imaging methods if associated with oligohydramnios. In these circumstances, the perinatal autopsy has a significant role in arriving at the final diagnosis which guides the clinician in predicting the recurrence risk and the need for genetic workup.
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Affiliation(s)
- Nidhya Ganesan
- Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu 641004, India
| | - Umamaheswari Gurusamy
- Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu 641004, India.
| | - Chaitra Venkataswamy
- Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu 641004, India
| | - Kavya Sankar
- Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu 641004, India
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Surgical reconstruction of abnormally located penis in urorectal septum malformation sequence: report of a case. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021. [DOI: 10.1007/s00238-020-01769-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ramya GM, Abiramalatha T, Balakrishnan U, Chinnathambi Narayanan S. Complete urorectal septal malformation with left hemimelia in a neonate: an uncommon association. BMJ Case Rep 2021; 14:e241423. [PMID: 33766971 PMCID: PMC8006830 DOI: 10.1136/bcr-2020-241423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Gurujala Mahadeva Ramya
- Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Thangaraj Abiramalatha
- Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
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Kunt İşgüder Ç, Kanat Pektaş M, Köseoğlu D, Takçı Ş. An Autopsy Case Report: Prune Belly Syndrome with Overlapping Presentation of Partial Urorectal Septum Malformation Sequence. Turk Patoloji Derg 2020; 36:64-67. [PMID: 30632118 PMCID: PMC10512687 DOI: 10.5146/tjpath.2018.01440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/31/2018] [Indexed: 11/18/2022] Open
Abstract
Prune belly syndrome (PBS) is characterized by a classical triad of congenitally absent abdominal muscles, bilateral cryptorchidism, and a malformed urinary tract. Urorectal septum malformation sequence (URSM) is identified with the absence of urogenital and anal openings. This case report describes a 15-week-old female fetus with megacystis, ascites and oligohydramnios in a 19-year-old nulliparous woman. The patient underwent preterm labor at the 33rd gestational week and delivered a female newborn weighing 2250 grams who died three days later due to progressive respiratory insufficiency. To the best of our knowledge, this is the third case of an overlap between PBS and URSM in literature. Such an overlap refers to the existence of left renal agenesis, right renal cystic dysplasia, bilateral club foot and lumbar scoliosis as well as the absence of abdominal wall muscles, internal genital organs, urethral, vaginal and anal openings. This case report aims to remind the obstetricians about the concurrent occurrence of PBS with URSM and its poor prognosis.
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Affiliation(s)
- Çiğdem Kunt İşgüder
- Department of Obstetrics and Gynecology, Istanbul University, School of Medicine Istanbul, Istanbul, Turkey
| | - Mine Kanat Pektaş
- Department of Kocatepe University, School of Medicine, Afyon, Turkey
| | - Doğan Köseoğlu
- Department of Pathology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
| | - Şahin Takçı
- Department of Pediatrics, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
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Mashavave N, Harrison D, Grieve A. Partial urorectal septum malformation sequence with prune belly syndrome and oesophageal atresia with a tracheoesophageal fistula. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2019. [DOI: 10.1016/j.epsc.2019.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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