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Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition

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A unique presentation and rare pathological finding for urachal sinus.

Bo Wang¹, Jun Tashiro, Liset Pelaez

¹DeWitt-Daughtry Family Department of Surgery, Division of Pediatric Surgery, Miami, FL 33136, USA.

Journal of Pediatric Surgery

|October 1, 2013

Summary

A 2-year-old girl had a urachal sinus diagnosed via ultrasound. The sinus tract showed concerning columnar epithelium, a potential precursor to urachal carcinoma.

Keywords:

Urachal carcinoma Urachal cyst Urachal sinus Urachus

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Area of Science:

Pediatric Surgery
Urology
Developmental Biology

Background:

The urachus is a remnant of the allantois, typically obliterating after birth.
Urachal anomalies, such as urachal sinuses, can lead to recurrent infections and, rarely, malignancy.
Early diagnosis and management are crucial for preventing complications.

Observation:

A 2-year-old female presented with a urachal sinus.
The sinus opening was located midline between the umbilicus and pubic symphysis.
Preoperative diagnosis was confirmed by ultrasound and intraoperative findings.

Findings:

The urachal sinus tract contained columnar epithelium within the abdominal wall.
This finding suggests a potential for metaplasia within the urachal remnant.
Histopathological examination confirmed the presence of this specific epithelial lining.

Implications:

The presence of columnar epithelium raises concerns for malignant transformation, specifically urachal carcinoma.
This case highlights the importance of thorough histopathological evaluation of urachal remnants.
Further surveillance or management strategies may be warranted in similar cases.