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一名青春期女孩的脐尿管腺癌:病例报告

Urachal adenocarcinoma in an adolescent girl: A case report.

作者信息

Ngowi Elisamia, Patel Sonal, Ally Pilly, Ngimba Caroline, Nyamuryekung'e Masawa Klint

机构信息

Department of Paediatrics and Child Health, Aga Khan Hospital Tanzania, P.O. Box 2289, Dar Es Salaam, Tanzania; Department of Paediatrics and Child Health, Aga Khan University, P.O. Box 38129, Dar Es Salaam, Tanzania.

Department of Paediatrics and Child Health, Aga Khan Hospital Tanzania, P.O. Box 2289, Dar Es Salaam, Tanzania; Department of Paediatrics and Child Health, Aga Khan University, P.O. Box 38129, Dar Es Salaam, Tanzania.

出版信息

Int J Surg Case Rep. 2025 Feb;127:110846. doi: 10.1016/j.ijscr.2025.110846. Epub 2025 Jan 6.

Abstract

INTRODUCTION

The urachus is a fetal canal that connects the allantois to the bladder and typically obliterates by the 6th month of gestation. Failure of the urachus to obliterate can result in urachal anomalies, which, in rare cases, may undergo malignant transformation.

CASE PRESENTATION

We present a case of a 13-year-old female who experienced hematuria, dysuria, and abdominal pain persisting for over 4 months. A CT scan revealed a mass extending from the bladder wall, involving an adjacent bowel loop, and associated with intra-abdominal lymphadenopathy. Debulking surgery was performed, and a histopathological examination confirmed the diagnosis of urachal adenocarcinoma.

DISCUSSION

Urachal anomalies are exceedingly rare, with malignancies arising from urachal remnants being even more uncommon. Most patients are diagnosed at advanced stages due to the late onset of symptoms, resulting in a five-year survival rate of approximately 50 %.

CONCLUSION

Urachal adenocarcinoma can occur in children, potentially due to early oncogenesis of urachal cells. It should be considered a significant differential diagnosis in children presenting with recurrent lower abdominal pain and a urachal remnant to facilitate early detection and timely management.

摘要

引言

脐尿管是一条连接尿囊与膀胱的胎儿管道,通常在妊娠第6个月时闭塞。脐尿管未能闭塞可导致脐尿管异常,在极少数情况下,可能会发生恶性转化。

病例报告

我们报告一例13岁女性病例,该患者出现血尿、排尿困难和腹痛持续超过4个月。CT扫描显示一个肿块从膀胱壁延伸,累及相邻肠袢,并伴有腹腔淋巴结肿大。进行了减瘤手术,组织病理学检查确诊为脐尿管腺癌。

讨论

脐尿管异常极为罕见,起源于脐尿管残余的恶性肿瘤更为少见。大多数患者因症状出现较晚而在晚期被诊断,导致五年生存率约为50%。

结论

脐尿管腺癌可发生于儿童,可能是由于脐尿管细胞的早期肿瘤发生。对于出现反复下腹痛且有脐尿管残余的儿童,应将其视为重要的鉴别诊断,以便早期发现并及时处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3ac/11760787/a6fdf3b4b2dd/gr1.jpg

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