An unusual presentation of Urachal Tumour
Ruth Reeve, Laura Durdle, Portsmouth Hospitals NHS Trust
Background
There are only around 350 cases of Urachal cancer described in the medical literature to date, accounting for 0.2% of all bladder cancers. Urachal cancer is a rare type of cancer arising from the urachus or its remnants. It is often difficult to diagnose and requires a multidisciplinary approach. Patients who present with early confined disease have a good prognosis. Whereas those with advanced disease have less promising outcomes.
Case Report
We report a 40 year old woman with no previous history, complaining of unprovoked right shoulder pain. Following an initial x-ray which demonstrated diffuse permeative disease, further imaging tests including ultrasound ultimately made the rare diagnosis of metastatic urachal malignancy, which was confirmed by biopsy.
Discussion
Advanced Ultrasound Practitioners should be aware of the role of ultrasound in the management of indeterminate pelvic masses. As ultrasound is often a first line imaging tool it is important to be aware of the appearances and be able to differentiate pelvic masses to exclude the rare diagnosis of urachal malignancy.