This is a 73-year-old patient who comes to gynecological consultation for metrorrhagia.
The examination revealed no gynecological pathology and she was referred to the urology service for study.
The patient has a history of previous hysterectomy 20 years ago for leiomyomas, and comes to urology consultation for four years due to pain, haematuria and recurrent urinary tract infections. The patient has been subjected to multiple pathology studies.
Later, he has followed periodic reviews, including cytologies and control cytoscopy with cold biopsy, without evidence of neoplasia.
When the patient was referred for gynecologic consultation, an ultrasound study showed a hypoechoic image adjacent to the bladder, indicating CT scan.
The pelvic CT scan described an oval tumor with well-defined contours, density soft parts, slightly heterogeneous, about 5 cm in maximum diameter, located adjacent to the left anterior margin of the bladder with an apparent density inical bladder wall.
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With the diagnosis of prevesical mass suspect desmoid cyst or persistent urachal tumor, surgical intervention is performed.
A midline laparotomy incision was performed with resection of the prevesical neoformative process associated with partial cystectomy.
The macroscopic study of the specimen describes an oval formation of elastic consistency measuring 8x4 cm, and the cut seems to correspond to a cystic formation filled with grey and friable material.
In the microscopic study it can be seen that the wall of this cavity is made up of fibromuscular tissue and from it is observed a grade III papillary neoplasia of transitional epithelium, which presents a fundamentally exophytic growth of the duct towards the wall.
Extreme attachment of the bladder muscle wall, included in one of the resection sites, without reaching the mucosa, does not involve urothelial neoplasia in the bladder lining epithelium.
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The patient has no remarkable incidents after the intervention, was discharged and remains asymptomatic at present.
