title: Multipathogenetic origin of a pelvic mass.
abstract: A 69-yr-old woman presented with a bulky hypogastric mass and abdominal pain. Computed tomography scan showed a mass anterosuperior and contiguous to the bladder wall, with a hypodense content, a voluminous bladder stone, and bilateral hydroureteronephrosis. Intraoperatively, the supravesical mass had the appearance of an infected urachal cyst. An unsuspected high-grade noninvasive papillary transitional cell carcinoma (TCC) of the bladder thoroughly surrounding the bladder stone became evident during the cystolithotomy. Postoperative videourodynamic study showed a normal voiding pattern with bilateral grade 4 vesicoureteral reflux. Early cystectomy was performed for uncontrolled recurrent bladder cancer, and the final pathology indicated pT1G3N0 TCC.
authors.affiliation: University of Turin, Molinette Hospital, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Oderda
authors.forename: Paolo
authors.initials: P
authors.lastname: Mondino
authors.forename: Andrea
authors.initials: A
authors.lastname: Zitella
authors.forename: Dario
authors.initials: D
authors.lastname: Vigna
authors.forename: Chiara
authors.initials: C
authors.lastname: Fiorito
authors.forename: Donatella
authors.initials: D
authors.lastname: Pacchioni
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tizzani
authors.forename: Paolo
authors.initials: P
authors.lastname: Gontero
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D015653:Cystectomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D007150:Immunohistochemistry; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D010386:Pelvic Neoplasms / Q000175:diagnosis / Q000601:surgery; D011183:Postoperative Complications / Q000503:physiopathology; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014496:Urachal Cyst / Q000000981:diagnostic imaging* / Q000601:surgery; D001744:Urinary Bladder Calculi / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014563:Urodynamics; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis