Urogenital sinus cyst in a 21-year-old man.

We report a case of a rare congenital malformation, a urogenital sinus cyst in a young patient with non-specific symptoms for several months. A 21-year-old male presented with vague and intermittent abdominal pain. Ultrasound scan showed a retrovesical hypoechoic collection (approximately 6 cm) and left renal agenesis, compatible with a possible congenital malformation. These findings were confirmed by MRI. A laparoscopic excision of the cyst was performed with no complications. Pathology report confirmed a urogenital sinus cyst. The postoperative recovery was uneventful and the patient was discharged within 48 h. Urogenital sinus cysts are rare entities with few cases described in the literature. Imaging techniques such as ultrasound, CT or MRI may help with diagnosis. Therapeutic modalities range from observation to needle aspiration or surgical removal. In our case, we chose a laparoscopic approach to minimize morbidity and achieve an early recovery.

Adenocarcinoma de uraco con metástasis cerebrales tardías / Urachal adenocarcinoma with late brain metastases

OBJETIVO: Describir un caso de adenocarcinoma uracal con metástasis cerebrales tardías en un paciente de 61 años que consultó por molestias abdominales y hematuria de 6 meses de evolución.MÉTODO: Con la sospecha clínica de tumoración vesical se realizaron pruebas diagnósticas (citología seriada de orina, cistoscopia, ecografía abdominal y TAC abdominopélvico). Se indicó tratamiento quirúrgico.RESULTADOS: La citología de orina fué negativa. En la cistoscopia se observó una lesión infiltrante en la cúpula vesical. En la ecografía y la TAC se apreció una lesión redondeada de 5 cm, con densidad intermedia, ecos internos ycalcificaciones en la línea media supravesical anterior, que infiltraba la vejiga. El estudio de extensión no mostró hallazgos. Se realizó cistectomía parcial y linfadenectomía. El diagnóstico histopatológico fué adenocarcinoma uracal mucosecretor. Tras 5 años libre de enfermedad el paciente desarrolló metástasis pulmonar y cerebrales.CONCLUSIONES: El adenocarcinoma de uraco es un tumor que debe distinguirse del adenocarcinoma primario vesical. El tipo mucosecretor puede asociar calcificaciones detectables en las pruebas de imagen que deben hacer sospechar el diagnóstico. La presencia de metástasis tardías (tras 5 años libre de enfermedad) y sin signos de recidiva local es un hecho clinicopatológico infrecuente(AU)

OBJECTIVE: To describe a case of urachal adenocarcinoma with late brain metastases in a sixtyone year old man who presented abdominal discomfort and hematuria during six months.METHODS: The clinical suspicion was bladder tumor and diagnostic studies were performed (urinary cytology, cys-toscopy, abdominal ultrasound and abdominopelvic CT scan). Surgical treatment was performed.RESULTS: Negative urinary cytology. Cystoscopy showed a lesion with infiltration of the bladder dome. Ultrasound and CT scan showed a five centimeter rounded lesion, with intermediate density, internal echoes and calcificatio-ns on the anterior supravesical middle line, that infiltrated the bladder. The extension study had not findings. Partial cystectomy and lymphadenectomy were performed. The histopathologic diagnosis was mucin-secreting urachal adenocarcinoma.After five years without disease the patient suffered lung and brain metastases.CONCLUSIONS: Urachal adenocarcinoma is a tumor which must be distinguished of primary bladder adeno-carcinoma. The mucing-secreting adenocarcinoma can be associated with calcifications that can be demostrated on imaging studies. Late metastases without signs of local recurrence (after five years without disease) are an infrequent clinical-pathologic finding(AU)