Computed tomography and ultrasound of a urachal cancer

Abstract

Malignant lesions of the urachus are rare. Fewer than 200 cases have been reported in the world literature. Prior to the advent of ultrasound and computed tomography (CT), radiography was said to be of limited value in the pre-operative diagnosis of these tumours (Beck et al, 1970). Urachal tumours have characteristic features on both ultrasound and CT scan, and these are well illustrated in our case. To our knowledge, this is the first time metastatic deposits from such a tumour have been documented on CT. A 66-year-old man presented with pain in his left hip. Radiography of his pelvis (Fig. 1) revealed an oval densely calcified pelvic mass 8–10 cm in diameter. Urography was normal. Ultrasound scanning (Fig. 2) showed a complex mass lying anteriorly, above the bladder and extending cephalad.