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Mizuta N, Kikuchi T, Ashitani H, Sano N. Mucinous Cystadenoma of the Urachal Remnant Successfully Resected by Laparoscopic Surgery: A Case Report. Cureus 2024; 16:e64790. [PMID: 39156387 PMCID: PMC11330288 DOI: 10.7759/cureus.64790] [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: 07/17/2024] [Indexed: 08/20/2024] Open
Abstract
A urachal remnant is a disorder resulting from a disturbance in the closure process of the urachus. A 55-year-old man was referred to our hospital for treatment of gallstones. The computed tomography scan revealed a cystic mass in the lower abdomen connecting to the urinary bladder. The preoperative diagnosis was a urachal cyst. Simultaneous laparoscopic cholecystectomy, mass resection, and urachectomy were performed. The mass on the cranial side of the urinary bladder was located on the median umbilical ligament. Both were resected and removed, along with the umbilicus. The postoperative course was uneventful. The histopathological diagnosis was urachal mucinous cystadenoma. There is no sign of a recurrence. A complete resection without damage is especially important for mucinous tumors of the urachal remnant because the injury to the tumor may lead to the development of pseudomyxoma peritonei. Only seven cases of mucinous cystadenoma of the urachal remnant were reported in English literature, and only one of these was treated with laparoscopic surgery. In our case, complete resection was possible by taking advantage of the magnifying effect of laparoscopic surgery. Furthermore, we are able to provide very clear intraoperative images and specimen photographs, which we believe will be useful for readers. Laparoscopic surgery will be beneficial when treating similar cases in the future. However, it should be kept in mind that a safe resection requires careful and meticulous technique.
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Affiliation(s)
| | | | | | - Nobuya Sano
- Diagnostic Pathology, Akashi Medical Center, Akashi, JPN
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Chen L, Di M, Sun L, Fu Q. Rare urachal mucinous cystic tumor of low malignant potential with peritoneal pseudomyxoma: A case report. Exp Ther Med 2023; 26:555. [PMID: 37941591 PMCID: PMC10628641 DOI: 10.3892/etm.2023.12254] [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: 05/06/2023] [Accepted: 09/13/2023] [Indexed: 11/10/2023] Open
Abstract
Mucinous cystic tumors of low malignant potential (MCTLMP) are rare urachal neoplasms. The morphological characteristics and clinical prognosis of MCTLMP is similar to that of mucinous cystic tumors occurring in the ovary and appendix. After complete resection, almost no cases of recurrence or metastasis have been reported. Because MCTLMP is rare, it may be missed in the clinic. MCTLMP can lead to the formation of pseudomyxoma peritonei (PMP), which manifests as the widespread production of mucus in the abdominal cavity and makes the disease complex or difficult to diagnose. At present, only 3 cases of MCTLMP with PMP have been reported in the literature. In the present study a fourth case of urachal MCTLMP in a 74-year-old male that resulted in widespread PMP is presented. Initially, a multilocular cystic lesion was revealed in the urachal duct area at the anterior upper margin of the bladder after a patient, experiencing lower abdominal pain, was imaged. As revealed using light microscopy, the cyst was lined with a mucous columnar epithelium, and part of the epithelium indicated pseudolamellar hyperplasia and papillary structures. The cells indicated mild atypia and low mitotic activity. There was no stromal infiltration of tumor cells, and a large amount of mucous exudate was observed. As preoperative computed tomography examination suggested the presence of a large amount of ascites and there were increased levels of blood tumor markers, carcinoembryonic antigen and carbohydrate antigen 125, clinicians considered that the diagnosis maybe a malignant tumor of the urachal gland with peripheral dissemination. However, the diagnosis of MCTLMP with PMP was confirmed by histopathological examination. The mass was completely removed, along with part of the peritoneum and bladder wall as these were within the tumor margin. The appendix appeared normal during surgery. A one off dose of intraperitoneal infusion chemotherapy with 1,000 mg 5-fluorouracil was performed after surgery. No recurrence was observed during the 8-month follow-up period.
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Affiliation(s)
- Lijiang Chen
- Department of Pathology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang 311200, P.R. China
| | - Meijuan Di
- Department of Pathology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang 311200, P.R. China
| | - Lijun Sun
- Department of Pathology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang 311200, P.R. China
| | - Qiong Fu
- Department of Pathology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang 311200, P.R. China
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Mylonakis A, Karydakis L, Davakis S, Panagakis A, Kaniadaki M, Pergaris A, Alexandrou A, Papalampros A, Sakarellos P. A Huge Asymptomatic Urachal Mucinous Cystic Carcinoma: A Case Report With Differential Diagnosis and Surgical Considerations. Cureus 2023; 15:e37036. [PMID: 37143634 PMCID: PMC10153764 DOI: 10.7759/cureus.37036] [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: 04/02/2023] [Indexed: 05/06/2023] Open
Abstract
Cystic mucinous neoplasms of urachal origin cover a wide spectrum of benign and malignant lesions arising from the remnants of the urachus. They display various degrees of tumor cell atypia and local invasion, with no reported cases of metastasis or recurrence after complete surgical resection. We present a 47-year-old man who referred to our Surgical Department due to an abdominal cystic mass incidentally found upon abdominal ultrasound. He underwent en block resection of the cystic mass along with partial bladder dome cystectomy. The histopathology of the resected specimen revealed a cystic mucinous epithelial tumor of low malignant potential with areas of intraepithelial carcinoma. The patient showed no evidence of disease recurrence or distant metastasis 6 months after resection and is scheduled for follow-up with serial MRI or CT scans and blood tumor markers over the next 5 years.
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Affiliation(s)
- Adam Mylonakis
- First Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Lysandros Karydakis
- First Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Spyridon Davakis
- First Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Andreas Panagakis
- First Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Maria Kaniadaki
- First Deparment of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Alexandros Pergaris
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Andreas Alexandrou
- First Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Alexandros Papalampros
- First Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Panagiotis Sakarellos
- First Department of Surgey, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, GRC
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Schmeusser B, Wiedemer J, Obery D, Buckley K, Yu M. Urachal mucinous cystic tumor of low malignant potential in a polymorbid female: a case report and review of the literature. Int Cancer Conf J 2022; 11:104-108. [PMID: 35402128 PMCID: PMC8938540 DOI: 10.1007/s13691-021-00530-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/21/2021] [Indexed: 11/28/2022] Open
Abstract
AbstractNeoplasms of the urachus are exceedingly rare, representing 0.17% of all bladder cancers. The mucinous cystic tumor of low malignant potential (MCTLMP) subtype is particularly rare with just 25 previous cases reported in the literature. Although rare, MCTLMPs are important to identify due to potential devastating complications and good cure rates with surgical removal. We present a 43 year old female with a nuanced constellation of comorbidities and confirmed MCTLMP following a workup for abdominal pain and irritative lower urinary tract symptoms. Notably, this tumor did not change in size over a 3-year course of serial imaging prior to surgical excision. This urachal MCTLMP represents roughly the 26th and one of the smallest of its subtype reported in the literature. This case illustrates the diagnosis and management of this rare urachal MCTLMP. Individual patient medical history, clinical considerations, and neoplasm characteristics are examined. Although rare, the potential for increased malignancy and potential complications necessitates surgical management and further investigation by the academic community.
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Affiliation(s)
- Benjamin Schmeusser
- Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Highway, Dayton, OH 45324 USA
| | - Joseph Wiedemer
- Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Highway, Dayton, OH 45324 USA
| | - Dana Obery
- Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Highway, Dayton, OH 45324 USA
| | - Kaila Buckley
- Department of Pathology, CORPath/Riverside Methodist Hospital Associates, Columbus, OH USA
| | - Michael Yu
- Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Highway, Dayton, OH 45324 USA
- Grant Medical Center, Ohio Health Urology, Columbus, OH USA
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Bogaert B, Tulelli B, Rodesch M, Pregardien C, Rorive S, Lingier P. Urachal mucinous cystadenoma in infant: First case report in infant and review of literature. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2021.101942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Agnihotri AK, Yagnik VD, Agnihotri S, Yagnik B. Mucinous cystadenomas of urachus: A case report and literature review. Urol Ann 2020; 12:291-294. [PMID: 33100759 PMCID: PMC7546063 DOI: 10.4103/ua.ua_118_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 06/19/2020] [Indexed: 11/04/2022] Open
Abstract
Urachal epithelial neoplasms are rare tumors that arise from the vestiges of the urachus. Mucinous cystadenomas are considered as a benign glandular tumors of the urachus. Cystadenomas are commonly found in the ovary, appendix, and pancreas. Mucinous cystadenomas of the urachus are extremely rare in the urachus, and only nine cases reported so far. We reported the 10th case of Mucinous cystadenomas of the urachus detected incidentally at the time of diagnostic laparoscopy for investigation of genitourinary tuberculosis.
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Affiliation(s)
- Arun Kumar Agnihotri
- Department of Pathophysiology, American University of Antigua College of Medicine, Antigua, Antigua and Barbuda, India
| | - Vipul D Yagnik
- Department of Surgical Gastroenterology, Nishtha Surgical Hospital and Research Centre, Patan, India
| | - Smriti Agnihotri
- Department of Pathophysiology, American University of Antigua College of Medicine, Antigua, Antigua and Barbuda, India
| | - Bhargav Yagnik
- Consultant Pathologist, Neberg Supratech Laboratory, Mehsana, Gujarat, India
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