Indian Journal of Radiology Indian Journal of Radiology  

   Login   | Users online: 2260

Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size     

 

GENITOURINARY Table of Contents   
Year : 2006  |  Volume : 16  |  Issue : 4  |  Page : 883-884
Case report: Ultrasound demonstration of urachal cyst cancer - a rare case


1 Dept of Radiology, B M Patil Medical College Hospital & Research Centre, Bangaramma Sajjan Campus, Bijapur, Karnataka, India
2 Dept of Radiology, STD, Urology and Pathology, B M Patil Medical College Hospital & Research Centre, Bangaramma Sajjan Campus, Bijapur, Karnataka, India

Click here for correspondence address and email

Date of Submission22-Jun-2005
Date of Acceptance10-Jun-2006
 

Keywords: Uractius, adenocarcinoma, Ultrasound

How to cite this article:
Korishetti S I, Inamadar A C, Patil S B, Patil G S. Case report: Ultrasound demonstration of urachal cyst cancer - a rare case. Indian J Radiol Imaging 2006;16:883-4

How to cite this URL:
Korishetti S I, Inamadar A C, Patil S B, Patil G S. Case report: Ultrasound demonstration of urachal cyst cancer - a rare case. Indian J Radiol Imaging [serial online] 2006 [cited 2019 Aug 24];16:883-4. Available from: http://www.ijri.org/text.asp?2006/16/4/883/32374

   Introduction Top


Urachal adenocarcinoma is extremely rare, accounting for less than 1% of the bladder cancers and 20-39 % of primary adenocarcinomas of the bladder [2]. Approximately 75% occur in men[5]. They have been reported in patients aged 4 months to more than 80 years[3]. These lesions are often silent until they reach an advanced stage, and their prognosis is worse than for nonurachal adenocarcinomas[2].

We report a case of urachal cyst carcinoma demonstrated by ultrasound using a 6.5 MHz real time sector probe.


   Clinical history Top


A Young male aged 31 years presented with pain in the abdomen since 3 years, haematuria and burning micuration since 2 months. Per abdominal examination revealed indurated mass at suprabubic region. No discharge from umbilicus.


   Relevant investigations Top


Ultrasound of suprapubic region [Figure - 1][Figure - 2] showed hypoechoic mass measuring 5 x 4 x 4 cms in the midline extending towards umbilicus subcutaneously. Sonography diagnosis of urachal solid mass suspected of malignancy.

Cystoscopy revealed a mass at the dome of urinary bladder measuring 6 x 5 cms and biopsy was done and the material was sent for histopathological examination.

Subsequently patient underwent enblock partial cystectomy and bilateral pelvic lymphnode dissection.

Morphology -Fungating bladder mass measures 10 x 10 x 7 cms with pale white, shiny, mucoid surface in continuation with cystic mass measuring 5 x 4 x 4 cms with ale white shiny mucoid surface. Nine lymphnodes of varying size were received, largest measuring 2 x 1 cm. Microscopic studies of bladder mass showed infiltration tumour with bimodal population of cells underlying the normal urothelium. One population of cells - round to polygonal with hyper chromatic eccentrically placed nuclei with abundant pale cytoplasm. The cells are arranged in lobular pattern. Another populaton of cells - round to oval with large hyperchromatic nucleus with moderate eosinophilic cytoplasm. The cells are arranged in lobular pattern and also in diffuse sheets. Invasion in the all layers of the bladder extending into the surrounding adipose tissue. [Figure - 3],[Figure - 4]. Cystic mass - tumour cells having similar morphology as mentioned above were noted. Obturator lymph node - showed metastatic deposits. Mucicarmine stain showed mucin positivity in the tumour cells.


   Discussion Top


The urachus is 5 to 6 cm long embryonic structure located between dome of bladder and the umbilicus [2]. Urachal cancer was described first in 1863 by Hue & Jaequin. Most of the urachal cancers are either mucin producing (60%) or nonmucin producing(15%) adenocarcinomas. Less common urachal neoplasms include sarcomas, transitional cell carcinomas and squamous cell carcinomas. Somes times are aassociated with urachal calculi and cysts[1]. Carcinomas may occur at any site along with urachal tract, but tumours at the umbilicus and dome of the bladder are more common than the intermediate sites[2]. Reported criteria for the diagnosis of the urachal carcinoma are

1. Tumour location in the dome of the bladder wall.

2. Demarcation between tumour and surface epithelium.

3. Exclusion of distant source[5].

Our case fulfilled all the three criteria mentioned above. Hence a final diagnosis of urachal adenocarcinoma of the bladder was made.

 
   References Top

1.Curtis A, Sheldon, et al : Malignant urachal lesions, The journal of urology 1984; 131: p 1-7.  Back to cited text no. 1    
2.Gillenwater JY, et al: Adult and Paedatric urology, Newyork, Mosby, 1996: p 1391-1392.  Back to cited text no. 2    
3.Murphy WM: Urological pathology, Philadelphia, WB Saunders, 1997; p 40-43.  Back to cited text no. 3    
4.M C Gee J, Isacson PG, Wright NA: Oxford Textbook of pathology, Oxford university press, 1992; p 1516-1517.  Back to cited text no. 4    
5.Silverberg SG : Principles and practice of surgical pathology and cytopathology, Newyork, Churchill Livingstone, 1997; p 2198-2199.   Back to cited text no. 5    

Top
Correspondence Address:
S I Korishetti
Department of Radiodiagnosis, Sri B M Patil Medical College Hospital Bijapur, Karnatak State
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.32374

Rights and Permissions


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Email Alert *
    Add to My List *
* Registration required (free)  


    Introduction
    Clinical history
    Relevant investi...
    Discussion
    References
    Article Figures

 Article Access Statistics
    Viewed6257    
    Printed75    
    Emailed0    
    PDF Downloaded221    
    Comments [Add]    

Recommend this journal