術前診断が困難であった尿膜管腫瘍の1例

概要

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Objective: To report a rare case of an urachal remnant cyst in the lower abdomen mimicking benign gynecologic disease. Case: A 50-year-old female presented with lower abdominal pain of three months duration. She had had a history of an abdominal myomectomy at age 39 and a cesarean section at age 40. Pelvic examination revealed a 7 cm midline cystic mass in the lower abdomen. Magnetic resonance imaging (NRI) revealed a cystic lesion near the apex of the bladder, without any significant signs of malignancy. We suspected the possibility of benign gynecologic disease such as an old hematoma or a foreign body granuloma. At laparoscopy, it was noted that the mass was primarily located in the extra corporeal space and directly connected to the bladder. Urologists completely resected the mass including the upper portion of the bladder, and it was pathologically proven to be a benign urachal cyst. Conclusion: A urachal remnant cyst is a rare disease, which prior to surgery is defined as a lower abdominal mass of unknown origin that could possibly represent a malignancy. Careful preoperative evaluation and an appropriate surgical procedure are important because urachal cancer possesses highly malignant potential.
日本産科婦人科内視鏡学会の論文