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[A case of infected urachal cyst in an 8-year-old boy]
M Yoshioka1, T Ogino, K Shimada
1Department of Urology, Hyogo College of Medicine.
Insights
An infected urachal cyst caused a bladder tumor in an 8-year-old boy, leading to hematuria and fever. Surgical removal confirmed persistent urachus with chronic inflammation, a rare pediatric condition.
Area of Science:
- Pediatric Urology
- Surgical Pathology
Background:
- The urachus, a remnant of the allantois, can develop cysts that may become infected.
- Infected urachal cysts are rare but can present with significant lower urinary tract symptoms.
Observation:
- An 8-year-old boy presented with hematuria, dysuria, fever, and a palpable abdominal mass.
- Imaging revealed a bladder tumor with a connection to the umbilicus, suggestive of a urachal anomaly.
- Initial biopsy ruled out malignancy, but symptoms persisted.
Findings:
- Pathological examination after partial cystectomy confirmed a persistent urachus with chronic inflammation.
- The urachal remnant mimicked a solid tumor, causing the presenting symptoms.
Implications:
- This case highlights the importance of considering urachal remnants in the differential diagnosis of pediatric bladder masses.
- Prompt diagnosis and surgical management are crucial for resolving symptoms and preventing complications associated with infected urachal cysts.
Abstract:
An 8-year-old boy with infected urachal cyst presenting with macroscopic hematuria, pain on urination and high fever attack is reported. He had recurrent episodes of cystitis. At admission, a quail-egg sized solid tumor was palpated in the midline of his lower abdomen. The urine was infected. Ultrasonographic examination revealed an oval tumor 2 x 2.7 cm in diameter at the dome of the bladder with a thin funicular structure running toward the umbilicus. Cystoscopy revealed a round tumor covered with hyperemic epithelia. Transurethral biopsy revealed no malignant lesions of the epithelia. Partial cystectomy with excision of the funicular urachal ligament was performed. The pathological findings were consistent with persistent urachus with chronic inflammation. We reviewed 210 cases of infected urachal cysts reported in the Japanese literature.