Exam Name : MD CT Lower abdomen 44502
้HISTORY: Case remnant urachus.
TECHNIQUES: The contiguous axial MDCT scan through the lower abdomen using a 64-slice MDCT scanner was performed in both before and after intravenous contrast media injection. The oral and rectal contrast media were also administered.
FINDINGS: The study reveals heterogeneous infiltrative pelvic mass with multiple low density areas abutting with bladder dome involving prostate gland, adjacent mesorectal fascia, lower midline anterior abdominal wall (from umbilical to pubic symphysis level) and appendix (with enlarged appendix = 1.0 cm in Max. thickness and fulfilled fluid content).
Extensive perivesical and associated pelvic fat stranding is seen. Diffuse nodular bladder wall thickening is seen.
Bilateral hydroureter and mild hydronephrosis with delayed excretory function is seen.
Adjacent small bowel, colonic and rectal wall thickening is seen.
Multiple ileocecal and mesenteric nodes (0.3-0.9 cm in short axis) are seen.
Visualized liver and spleen are unremarkable. Portal vein is well opacified.
No evidence of boliary system dilataion is seen.
Gallbladder appears normal without evidence of gallstone.
Spleen, pancreas and both adrenal glands appear normal.
Visualized both basal lungs are unremarkable. No Bony destruction is seen.
IMPRESSION: From the above findings, urachal cancer with bladder and adjacent organ invasion as described above and suspected ilecocecal and mesenteric nodal metastases is consideted. However, severe extensive inflammation of urachal remnant is in DDx.