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Multipathogenetic origin of a pelvic mass
Marco Oderda1, Paolo Mondino, Andrea Zitella
1University of Turin, Molinette Hospital, Turin, Italy.
European Urology
|January 10, 2009
Summary
A bladder stone complicated a urachal cyst in a 69-year-old woman, revealing an unsuspected high-grade transitional cell carcinoma (TCC). Recurrent bladder cancer necessitated a cystectomy, highlighting the importance of thorough evaluation.
Area of Science:
- Urology
- Oncology
- Radiology
Background:
- A 69-year-old woman presented with abdominal pain and a hypogastric mass.
- Computed tomography revealed a supravesical mass, bladder stone, and bilateral hydroureteronephrosis.
Observation:
- Intraoperative findings suggested an infected urachal cyst.
- Cystolithotomy uncovered a high-grade noninvasive papillary transitional cell carcinoma (TCC) of the bladder surrounding the stone.
Findings:
- Postoperative videourodynamic study demonstrated a normal voiding pattern with bilateral grade 4 vesicoureteral reflux.
- Final pathology after cystectomy confirmed pT1G3N0 TCC, indicating recurrent bladder cancer.
Implications:
- This case underscores the potential for bladder cancer to present insidiously alongside common conditions like bladder stones.
- Prompt and thorough surgical intervention is crucial for managing complex urological presentations involving malignancy.
- Further investigation into the association between urachal cyst anomalies and bladder cancer may be warranted.
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