Urachal borderline mucinous cystadenoma: A rare case report and literature review

Abstract

Rationale: Urachal borderline mucinous cystadenoma is very rare and has only 9 cases in the current literature with the biological behavior between adenoma and adenocarcinoma.

Patient concerns: We reported a 41-year-old man with moderate lower abdominal pain, and the imaging examination found an irregular cystic lesion extending from umbilicus to the dome of urinary bladder with significant separations and calcifications.

Diagnoses: The diagnosis was confirmed according to the specific anatomical location and pathological examination which was proved as mucinous cystadenoma with low malignant potential.

Interventions: The patient undertook radical excision and partial cystectomy.

Outcomes: His postoperative condition was good.

Lessons: Urachal borderline mucinous cystadenoma can be located by image examination, which may also offer several diagnostic tips according to separation, calcification, and enhancement in computed tomography scan. When combined with pathological findings, qualitative diagnosis can be determined. Surgical resection should be chosen as an optimal treatment. Our present study reviewed the clinical and biological information of all previous cases which were diagnosed as urachal borderline mucinous cystadenoma and we supplemented more data for further study.

Figure 1

Abdominal plain CT scan revealed a hypo-dense mass with calcification (A) and lobulated shape (B) in enterocoelia extending from umbilicus to anterosuperior dome of bladder (C). CT = computed tomography.

Figure 2

Abdominal plain CT scan revealed an irregular hypo-dense lesion with higher dense shadow at the margin of cystic wall (A). Contrast-enhanced CT scan showed no obvious enhancement in both arterial (B) and portal phase (C). The marginal shadow showed mild enhancement in delayed phase (D). CT = computed tomography.

Figure 3

Histological presentation of urachal borderline mucinous cystadenoma. (A) Normal region of cystic wall was lined by single columnar epithelium. (B) The region of tumor showed glandular epithelial dysplasia with deeply stained nuclei and pseudostratified epithelium. (C) The underlying stroma is full of mucus and without invasion of tumor cells. (D) The calcification is found as blue particles or pieces.