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| Year : 2006 | Volume
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| Issue : 4 | Page : 883-884 |
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| Case report: Ultrasound demonstration of urachal cyst cancer - a rare case |
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SI Korishetti1, AC Inamadar2, SB Patil2, GS Patil2
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 Submission | 22-Jun-2005 |
| Date of Acceptance | 10-Jun-2006 |
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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 2021 Feb 27];16:883-4. Available from: https://www.ijri.org/text.asp?2006/16/4/883/32374 |
 Introduction | |  |
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 | | |
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 | | |
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 | | |
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 | | |
| 1. | Curtis A, Sheldon, et al : Malignant urachal lesions, The journal of urology 1984; 131: p 1-7.  |
| 2. | Gillenwater JY, et al: Adult and Paedatric urology, Newyork, Mosby, 1996: p 1391-1392. |
| 3. | Murphy WM: Urological pathology, Philadelphia, WB Saunders, 1997; p 40-43. |
| 4. | M C Gee J, Isacson PG, Wright NA: Oxford Textbook of pathology, Oxford university press, 1992; p 1516-1517. |
| 5. | Silverberg SG : Principles and practice of surgical pathology and cytopathology, Newyork, Churchill Livingstone, 1997; p 2198-2199. |
Correspondence Address:
S I Korishetti
Department of Radiodiagnosis, Sri B M Patil Medical College Hospital Bijapur, Karnatak State
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0971-3026.32374
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4] |
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