Primary urachal leiomyosarcoma: a case report and literature review of clinical, pathological, and medical imaging features

Jing Yan; Hongwei Li; Gaowu Yan; Qing Duan; Chunyan Tang; Morgan A McClure; Anup Bhetuwal; Yong Li; Ling Yang; Ruyi Li; Gangcheng Tan; Bo Feng

doi:10.3389/fonc.2023.1228178

Primary urachal leiomyosarcoma: a case report and literature review of clinical, pathological, and medical imaging features

Front Oncol. 2023 Aug 17:13:1228178. doi: 10.3389/fonc.2023.1228178. eCollection 2023.

Authors

Jing Yan¹, Hongwei Li², Gaowu Yan¹, Qing Duan¹, Chunyan Tang¹, Morgan A McClure³, Anup Bhetuwal⁴, Yong Li¹, Ling Yang⁵, Ruyi Li⁶, Gangcheng Tan⁶, Bo Feng⁶

Affiliations

¹ Department of Radiology, Suining Central Hospital, Suining, China.
² Department of Radiology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China.
³ Department of Radiology and Imaging, Institute of Rehabilitation and Development of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China.
⁴ Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
⁵ Department of Pathology, Suining Central Hospital, Suining, China.
⁶ Department of Radiology, Lixian People's Hospital, Aba, China.

Abstract

Background: Urachal tumors are exceedingly rare, and adenocarcinoma is the most common malignant urachal neoplasm. Here, an especially rare patient of primary urachal leiomyosarcoma from our hospital was reported, and only five patients have been reported thus far since 1981.

Case description: A 24-year-old man was admitted due to urinary tract symptoms. Both urogenital ultrasonography and contrast-enhanced computed tomography showed a mass at the dome of the urinary bladder. Laparoscopic surgical resection was performed, and histopathologic examination of the mass confirmed the diagnosis of urachal leiomyosarcoma. No recurrence was noted after one and a half years.

Conclusions: Because the leiomyosarcoma located in the extraperitoneal space of Retzius and may manifest with nonspecific abdominal or urinary symptoms, early and definitive preoperative diagnosis is challenging. Partial cystectomy with complete excision of the urachus is recommended. Because only a few patients have been recorded, clinical outcomes and recurrence risks are difficult to assess.

Keywords: case report; computed tomography; leiomyosarcoma; urachal tumor; urachus.

Publication types

Case Reports

Grants and funding

This study was supported by grants from the Sichuan Provincial Commission of Health (No. 19PJ284), the Science and Technology Association of Suining City (No. 6), and the Suining Central Hospital (Nos. 2021y09 and 2022ypj01).