Presentation
Incidental finding on trauma CT. No symptoms from the urogenital system.
Patient Data
Cystic structure localized about halfway between the bladder and the umbilicus, along the median umbilical (urachal) ligament. The finding is best appreciated in the sagittal projection.
Case Discussion
The urachus is a remnant of two embryonic structures: the cloaca and the allantois. The urachal cyst is the next commonest congenital anomaly related to the incomplete involution of the urachus. It is often discovered as an incidental finding, like in this case. It can also present with symptoms, as it predisposes for infection. However, the urachal cyst is less prone for infection than its siblings the vesicourachal diverticulum, the umbilical-urachal sinus and the patent urachus; for obvious reasons.
Urachal cysts may undergo malignant transformation, usually in the form of adenocarcinoma 1. Although urachal neoplasms are attributed to a very small percentage of bladder cancers, 34% of bladder adenocarcinomas are urachal in origin 2.
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