Case Of the Week (COW) 17 May 2015
Urachal remnant calcification with secondary infection
Findings
Small soft tissue density lesion (~ 18 x 10 mm) with calcification (~ 7 mm) noted abutting the antero-superior dome of the urinary bladder in the midline along the expected course of the urachal remnant. On contrast administration mild enhancement noted.
Discussion
The urachus, or median umbilical ligament, is a midline tubular structure that extends upward from the anterior dome of the bladder toward the umbilicus. It is a vestigial remnant of at least two embryonic structures: the cloaca, which is the cephalic extension of the urogenital sinus (a precursor of the fetal bladder), and the allantois, which is a derivative of the yolk sac The tubular urachus normally involutes before birth, remaining as a fibrous band with no known function. Occasionally, theurachusmaypersistandresultina varietyofclinicalproblems Four congenitalurachalanomaliescanoccur,including patent urachus,urachalcyst,umbilical-urachal sinus,vesicourachaldiverticul calcification withina urachal remnant close to its insertion into the urinary bladder wall tha tmimicsa bladder wall calcification on CT imaging , as in our case is unusual.
Contributed By:
Dr. S Babu Peter
Barnard Institute of Radiology, Anderson Diagnostics
Urachal remnant calcification with secondary infection
Findings
Small soft tissue density lesion (~ 18 x 10 mm) with calcification (~ 7 mm) noted abutting the antero-superior dome of the urinary bladder in the midline along the expected course of the urachal remnant. On contrast administration mild enhancement noted.
Discussion
The urachus, or median umbilical ligament, is a midline tubular structure that extends upward from the anterior dome of the bladder toward the umbilicus. It is a vestigial remnant of at least two embryonic structures: the cloaca, which is the cephalic extension of the urogenital sinus (a precursor of the fetal bladder), and the allantois, which is a derivative of the yolk sac The tubular urachus normally involutes before birth, remaining as a fibrous band with no known function. Occasionally, theurachusmaypersistandresultina varietyofclinicalproblems Four congenitalurachalanomaliescanoccur,including patent urachus,urachalcyst,umbilical-urachal sinus,vesicourachaldiverticul calcification withina urachal remnant close to its insertion into the urinary bladder wall tha tmimicsa bladder wall calcification on CT imaging , as in our case is unusual.
Contributed By:
Dr. S Babu Peter
Barnard Institute of Radiology, Anderson Diagnostics