Urachal Xanthogranuloma: Laparoscopic Excision with Minimal Incision

Sungchan Park; Young Hwan Ji; Sang Hyeon Cheon; Young Min Kim; Kyung Hyun Moon

doi:10.4111/kju.2009.50.7.714

Journal List > Korean J Urol > v.50(7) > 1005378

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Park, Ji, Cheon, Kim, and Moon: Urachal Xanthogranuloma: Laparoscopic Excision with Minimal Incision

Original Article

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

Published online: 19 July 2009

DOI: https://doi.org/10.4111/kju.2009.50.7.714

Urachal Xanthogranuloma: Laparoscopic Excision with Minimal Incision

Sungchan Park, Young Hwan Ji, Sang Hyeon Cheon, Young Min Kim¹, Kyung Hyun Moon

¹From the Departments of Urology and Pathology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea

Correspondence to: Kyung Hyun Moon Deptartment of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 290-3, Jeonha-dong, Dong-gu, Ulsan 682-714, Korea TEL: 052-250-7190 FAX: 052-250-7198 E-mail: urofirst@uuh.ulsan.kr

Received 5 March 2009 Accepted 29 June 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Urachal cyst, Xanthogranulomatous pyelonephritis, Laparoscopy

REFERENCES

1.Yamamoto T., Mori Y., Katoh Y., Iguchi M., Minamidari K., Sawai Y, et al. A case of urachal xanthogranuloma suspected to be a urachal tumor. Hinyokika Kiyo. 2004. 50:493–5.

2.Carrere W., Gutiérrez R., Umbert B., Solé M., Menéndez V., Carretero P. Urachal xanthogranulomatous disease. Br J Urol. 1996. 77:612–3.

3.Diaz Candamio MJ., Pombo F., Arnal F., Busto L. Xanthogranulomatous urachitis: CT findings. J Comput Assist Tomogr. 1998. 22:93–5.

4.Kuo TL., Cheng C. Xanthogranulomatous Inflammation of urachus mimicking urachal carcinoma. Urology. 2009. 73:443.

5.Tian J., Ma JH., Li CL., Xiao ZD. Urachal mass in adults: clinical analysis of 33 cases. Zhonghua Yi Xue Za Zhi. 2008. 88:820–2.

6.Navarrete S., Sánchez Ismayel A., Sánchez Salas R., Sánchez R., Navarrete Llopis S. Treatment of urachal anomalies: a minimally invasive surgery technique. JSLS. 2005. 9:422–5.

7.Wadhwa P., Kolla SB., Hemal AK. Laparoscopic en bloc partial cystectomy with bilateral pelvic lymphadenectomy for urachal adenocarcinoma. Urology. 2006. 67:837–43.

8.Kim DY., Kim HS., Kim IK., Moon I., Kim TS., Choi S, et al. Xanthogranulomatous cystitis presenting as a urachal carcinoma. Korean J Urol. 2004. 45:1180–2.

9.Han DH., Choi HJ., Kim JH., Shin JS., Chung KJ., Choi HY, et al. Xanthogranulomatous cystitis. Korean J Urol. 2004. 45:958–61.

10.Fornari A., Dambros M., Teloken C., Hartmann AA., Kolling J., Seben R. A case of xanthogranulomatous cystitis. Int Urogy-necol J Pelvic Floor Dysfunct. 2007. 18:1233–5.

Fig. 1

Preoperative computed tomography revealed a urachal mass.

Fig. 2

Cystoscopic findings showed that the anterior bladder had inflammatory changes.

Fig. 3

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

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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