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Urachal Mucinous Cystadenocarcinoma
Ryan Pereira1, Stephen McGeorge2, Marlon Perera1
1Urology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
BMJ Case Reports
|January 25, 2019
Summary
A large cystic urachal remnant caused pelvic fullness in a 57-year-old man. Surgical excision successfully removed the mass, resolving the patient's symptoms.
Area of Science:
- Urology
- Surgical Oncology
Background:
- A 57-year-old male presented with a 6-month history of pelvic fullness.
- He denied lower urinary tract symptoms or altered bowel habits.
Observation:
- Physical examination revealed a non-tender pelvic mass extending from the pubic symphysis to the umbilicus.
- Abdominal CT showed a 22×11×11 cm cystic mass originating in the pelvis.
- Flexible cystoscopy indicated external compression of the bladder wall.
Findings:
- Blood tests were largely unremarkable, with a slightly elevated carcinoembryonic antigen (CEA) of 7.6 ng/mL.
- The cystic mass was identified as a urachal remnant.
- The patient underwent successful open excision of the urachal remnant, partial cystectomy, partial anterior abdominal wall excision, and pelvic lymphadenectomy.
Implications:
- This case highlights the importance of considering urachal remnants in the differential diagnosis of pelvic masses.
- Complete surgical excision is an effective treatment for symptomatic urachal remnants.
- Postoperative imaging confirmed successful removal and resolution of bladder compression.
