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Malignant Transformation of An Urachal Cyst

Malignant Transformation of An Urachal Cyst

Clinical Image

A 27-year-old man presented to our hospital for abdominal pain and a cheesy discharge from the umbilicus which lasted for a few days. He was afebrile. The physical examination revealed periumbilical tenderness and discharge from the umbilicus. There were no signs of general infection. Otherwise, he had neither specific symptoms nor a palpable abdominal mass. Pelvic Computerized Tomographic (CT) scanning) confirmed the presence of a cyst in the midline of the abdominal wall, with communication with the bladder and peripheral calcification. The mass was infiltrated to the perivesical fat (Figure 1). The patient was prepared for surgery. During laparotomy, a urachal cyst with the cuff of the bladder dome were removed (Figure 2). Recovery was unremarkable. The resected specimen was a partial cystectomy specimen with perivesical fat and the median umbilical ligament (Figure 3A) Microscopically, Carcinomatous proliferation arranged in glandular structures and isolated cells, ring-like appearance, within pools of mucus. Infiltration of the detrusor muscle (star) with peri-nervous sheath

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