Mizuta Noritoshi, Kikuchi Takuya, Ashitani Hiroshi, Sano Nobuya
Surgery, Akashi Medical Center, Akashi, JPN.
Diagnostic Pathology, Akashi Medical Center, Akashi, JPN.
Cureus. 2024 Jul 18;16(7):e64790. doi: 10.7759/cureus.64790. eCollection 2024 Jul.
A urachal remnant is a disorder resulting from a disturbance in the closure process of the urachus. A 55-year-old man was referred to our hospital for treatment of gallstones. The computed tomography scan revealed a cystic mass in the lower abdomen connecting to the urinary bladder. The preoperative diagnosis was a urachal cyst. Simultaneous laparoscopic cholecystectomy, mass resection, and urachectomy were performed. The mass on the cranial side of the urinary bladder was located on the median umbilical ligament. Both were resected and removed, along with the umbilicus. The postoperative course was uneventful. The histopathological diagnosis was urachal mucinous cystadenoma. There is no sign of a recurrence. A complete resection without damage is especially important for mucinous tumors of the urachal remnant because the injury to the tumor may lead to the development of pseudomyxoma peritonei. Only seven cases of mucinous cystadenoma of the urachal remnant were reported in English literature, and only one of these was treated with laparoscopic surgery. In our case, complete resection was possible by taking advantage of the magnifying effect of laparoscopic surgery. Furthermore, we are able to provide very clear intraoperative images and specimen photographs, which we believe will be useful for readers. Laparoscopic surgery will be beneficial when treating similar cases in the future. However, it should be kept in mind that a safe resection requires careful and meticulous technique.
脐尿管残余是一种因脐尿管闭合过程紊乱而导致的病症。一名55岁男性因胆结石前来我院接受治疗。计算机断层扫描显示下腹部有一个与膀胱相连的囊性肿物。术前诊断为脐尿管囊肿。同时进行了腹腔镜胆囊切除术、肿物切除术和脐尿管切除术。膀胱上方的肿物位于脐正中韧带处。连同脐部一起将两者切除。术后病程顺利。组织病理学诊断为脐尿管黏液性囊腺瘤。无复发迹象。对于脐尿管残余的黏液性肿瘤，无损地完整切除尤为重要，因为肿瘤损伤可能导致腹膜假黏液瘤的发生。英文文献中仅报道了7例脐尿管残余黏液性囊腺瘤病例，其中仅1例接受了腹腔镜手术治疗。在我们的病例中，利用腹腔镜手术的放大效应得以完整切除。此外，我们能够提供非常清晰的术中图像和标本照片，我们认为这将对读者有所帮助。未来治疗类似病例时，腹腔镜手术将有益处。然而，应牢记安全切除需要细致入微的技术。
