Korean J Urol.  2009 Jul;50(7):714-717.

Urachal Xanthogranuloma: Laparoscopic Excision with Minimal Incision

• Park S
• Ji YH
• Cheon SH
• Kim YM
• Moon KH

Abstract

Urachal xanthogranuloma is an extremely rare disease. A 23-year-old man presented with severe lower abdominal pain and voiding frequency. Computed tomography revealed a urachal mass with bladder invasion, which was suspected to be a urachal carcinoma or abscess. Laparoscopic urachal resection was performed with a minimal incision. Histopathologic examination identified the mass as a urachal xanthogranuloma.

Keyword

Urachal cyst; Xanthogranulomatous pyelonephritis; Laparoscopy

MeSH Terms

Abdominal Pain
Abscess
Humans
Laparoscopy
Pyelonephritis, Xanthogranulomatous
Rare Diseases
Urachal Cyst
Urinary Bladder
Urinary Bladder Neoplasms
Young Adult
Urinary Bladder Neoplasms

Figure

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  Fig. 1 Preoperative computed tomography revealed a urachal mass.

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  Fig. 2 Cystoscopic findings showed that the anterior bladder had inflammatory changes.

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  Fig. 3 Laparoscopic excision of the urachus. By use of a “twist and roll” action, the urachus was twirled around the grasping forceps.8

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  Fig. 4 (A) Gross Specimen. The mass is transected and shows a yellowish necrotic area between adipose tissues. (B) Microphotography showing urachal remnant (center) and inflammatory changes (H&E, x20). (C) Infiltration of foamy histiocytes favoring xanthogranulomatous changes (H&E, x200). The right lateral side is a smooth muscle of bladder (normal). (D) Lesion showing typical lipid-laden histiocytes with fine cytoplasmic vacuolization and scattered lymphocytes (H&E, x400).

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