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Infected inguinal hernia mesh presenting as pseudotumor of the bladder.

Dubbeling RM, Ramesh K - Indian J Urol (2013)

Bottom Line: Imaging investigations revealed an abdominal mass arising from the wall of the urinary bladder.During dissection, we found a tumor arising from the urinary bladder infiltrating the posterior wall of rectus muscles and further dissection revealed presence of the previously placed inguinal mesh.Postoperative histopathological examination revealed inflammatory pseudotumor.

View Article: PubMed Central - PubMed

Affiliation: VU University Medical Center, Amsterdam, The Netherlands.

ABSTRACT
Pseudotumors are uncommon benign tumors considered as a reactive inflammatory lesion. We report a case of a 53-year-old male with a history of right laparoscopic hernia repair and now referred for suspected urachal cyst. Imaging investigations revealed an abdominal mass arising from the wall of the urinary bladder. During dissection, we found a tumor arising from the urinary bladder infiltrating the posterior wall of rectus muscles and further dissection revealed presence of the previously placed inguinal mesh. Postoperative histopathological examination revealed inflammatory pseudotumor. With only one comparable case described, an infected mesh presenting as pseudotumor of the bladder is extremely rare.

No MeSH data available.


Related in: MedlinePlus

Abdominal CT scan showing (a): axial, (b): saggital, a lesion with heterogeneous solid components and thickening of anterior bladder wall (arrow)
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Figure 1: Abdominal CT scan showing (a): axial, (b): saggital, a lesion with heterogeneous solid components and thickening of anterior bladder wall (arrow)

Mentions: He was diabetic and had undergone a laparoscopic inguinal hernia mesh repair 2 years previously. Physical examination revealed some abdominal tenderness. Urine sediment and culture showed no abnormalities, laboratory findings were normal and abdominal computed tomography (CT) scan confirmed a urachal cyst [Figure 1]. Preoperative cystoscopy showed normal bladder mucosa. The patient deferred intervention for 9 months for personal reasons. On laparotomy, a 10-12 cm fibrous nodular mass was seen arising from the dome of the urinary bladder, fixed to the right posterior surface of the rectus muscles. Because the procedure was performed late at night, no pathologist was available so frozen section could not be done. Because of its malignant appearance, we considered the risk of invasion and metastasis very likely, what resulted in discontinuation of the procedure. Incisional biopsy was taken and procedure was deferred until histopathological examination was done. Because the preoperative CT scan had become dated, we repeated an abdominal CT scan postoperative, which showed a lesion with heterogeneous solid components and thickening of anterior bladder wall [Figure 1]. Histopathological examination revealed fibroinflammatory tissue.


Infected inguinal hernia mesh presenting as pseudotumor of the bladder.

Dubbeling RM, Ramesh K - Indian J Urol (2013)

Abdominal CT scan showing (a): axial, (b): saggital, a lesion with heterogeneous solid components and thickening of anterior bladder wall (arrow)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3822352&req=5

Figure 1: Abdominal CT scan showing (a): axial, (b): saggital, a lesion with heterogeneous solid components and thickening of anterior bladder wall (arrow)
Mentions: He was diabetic and had undergone a laparoscopic inguinal hernia mesh repair 2 years previously. Physical examination revealed some abdominal tenderness. Urine sediment and culture showed no abnormalities, laboratory findings were normal and abdominal computed tomography (CT) scan confirmed a urachal cyst [Figure 1]. Preoperative cystoscopy showed normal bladder mucosa. The patient deferred intervention for 9 months for personal reasons. On laparotomy, a 10-12 cm fibrous nodular mass was seen arising from the dome of the urinary bladder, fixed to the right posterior surface of the rectus muscles. Because the procedure was performed late at night, no pathologist was available so frozen section could not be done. Because of its malignant appearance, we considered the risk of invasion and metastasis very likely, what resulted in discontinuation of the procedure. Incisional biopsy was taken and procedure was deferred until histopathological examination was done. Because the preoperative CT scan had become dated, we repeated an abdominal CT scan postoperative, which showed a lesion with heterogeneous solid components and thickening of anterior bladder wall [Figure 1]. Histopathological examination revealed fibroinflammatory tissue.

Bottom Line: Imaging investigations revealed an abdominal mass arising from the wall of the urinary bladder.During dissection, we found a tumor arising from the urinary bladder infiltrating the posterior wall of rectus muscles and further dissection revealed presence of the previously placed inguinal mesh.Postoperative histopathological examination revealed inflammatory pseudotumor.

View Article: PubMed Central - PubMed

Affiliation: VU University Medical Center, Amsterdam, The Netherlands.

ABSTRACT
Pseudotumors are uncommon benign tumors considered as a reactive inflammatory lesion. We report a case of a 53-year-old male with a history of right laparoscopic hernia repair and now referred for suspected urachal cyst. Imaging investigations revealed an abdominal mass arising from the wall of the urinary bladder. During dissection, we found a tumor arising from the urinary bladder infiltrating the posterior wall of rectus muscles and further dissection revealed presence of the previously placed inguinal mesh. Postoperative histopathological examination revealed inflammatory pseudotumor. With only one comparable case described, an infected mesh presenting as pseudotumor of the bladder is extremely rare.

No MeSH data available.


Related in: MedlinePlus