Multipathogenetic origin of a pelvic mass

Eur Urol. 2009 May;55(5):1224-8. doi: 10.1016/j.eururo.2008.12.023. Epub 2008 Dec 31.

Abstract

A 69-yr-old woman presented with a bulky hypogastric mass and abdominal pain. Computed tomography scan showed a mass anterosuperior and contiguous to the bladder wall, with a hypodense content, a voluminous bladder stone, and bilateral hydroureteronephrosis. Intraoperatively, the supravesical mass had the appearance of an infected urachal cyst. An unsuspected high-grade noninvasive papillary transitional cell carcinoma (TCC) of the bladder thoroughly surrounding the bladder stone became evident during the cystolithotomy. Postoperative videourodynamic study showed a normal voiding pattern with bilateral grade 4 vesicoureteral reflux. Early cystectomy was performed for uncontrolled recurrent bladder cancer, and the final pathology indicated pT1G3N0 TCC.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / etiology
  • Aged
  • Carcinoma, Transitional Cell / diagnostic imaging
  • Carcinoma, Transitional Cell / pathology*
  • Carcinoma, Transitional Cell / surgery
  • Cystectomy / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Hydronephrosis / diagnostic imaging
  • Hydronephrosis / physiopathology
  • Immunohistochemistry
  • Neoplasm Invasiveness / pathology*
  • Neoplasm Staging
  • Pelvic Neoplasms / diagnosis
  • Pelvic Neoplasms / surgery
  • Postoperative Complications / physiopathology
  • Risk Assessment
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Urachal Cyst / diagnostic imaging*
  • Urachal Cyst / surgery
  • Urinary Bladder Calculi / diagnostic imaging
  • Urinary Bladder Calculi / pathology*
  • Urinary Bladder Calculi / surgery
  • Urinary Bladder Neoplasms / diagnostic imaging
  • Urinary Bladder Neoplasms / pathology*
  • Urinary Bladder Neoplasms / surgery
  • Urodynamics
  • Vesico-Ureteral Reflux / diagnosis