Management of the giant umbilical cord: challenging the need for investigations in the newborn

Young, Simone; McGeechan, Anne; Davidson, Patricia M.; Deshpande, Aniruddh V.

doi:10.1136/archdischild-2016-311092

Cited by 10 publications

(9 citation statements)

References 5 publications

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“…The urachus is a vestigial remnant derived from the embryonic tissue connecting the allantois to the urinary bladder [34]. In fetal development, the urachus regresses to form the median umbilical ligament [35]. Incomplete regression of the urachus can give rise to urachal fistulas, cysts, and rarely neoplasms later in life [34].…”

Section: Discussionmentioning

confidence: 99%

Urachal Mucinous Cystic Tumor of Low Malignant Potential with Concurrent Sigmoid Colon Adenocarcinoma

Brennan

Johnson

Curtis

et al. 2019

Case Reports in Gastrointestinal Medicine

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Urachal mucinous tumors are rare neoplasms with behaviour that can range from relatively benign to malignancy that can spread distantly or throughout the peritoneum as pseudomyxoma peritonei or peritoneal carcinomatosis. Here we describe a unique case of urachal mucinous cystic tumor of low malignant potential confined to an intact cyst at the dome of the urinary bladder, without rupture or peritoneal spread. The urachal mucinous tumor was an incidental finding on a staging CT scan performed for sigmoid colon adenocarcinoma. We believe that this case illustrates a potential diagnostic pitfall which could have prognostic and therapeutic implications. Due to the intestinal phenotype of these neoplasms, a urachal tumor of low malignant potential could be mistaken for metastatic spread from a colonic adenocarcinoma in the rare situation such as this case, where the two neoplasms occur concurrently.

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Section: Discussionmentioning

confidence: 99%

Urachal Mucinous Cystic Tumor of Low Malignant Potential with Concurrent Sigmoid Colon Adenocarcinoma

Brennan

Johnson

Curtis

et al. 2019

Case Reports in Gastrointestinal Medicine

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“…The bladder descends into the pelvis at the same time. The urachus closes to become an umbilical median ligament in the embryonic evolution process [ 2 ]. Sometimes it undergoes an incomplete atresia and it can become the primary site of various lesions, such as cyst, fistula, neoplasia and diverticulum [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Urachal Carcinoma, An Unusual Possibility of Hematuria; Case Report and Literature Review

Tiutiuca¹,

Pușcașu

Ţarcă

et al. 2022

Diagnostics

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Urachal cancer is very rare, accounting for only 0.5–2% of bladder-associated malignancies and 0.01% of all cancers in adults. It has an insidious appearance, an aggressive behavior and a poor prognosis. The most common symptoms are hematuria and the presence of a palpable hypogastric mass. The scarcity of cases and the low number of studies carried out explains the lack of an evidence-based management strategy, but it seems that surgical treatment (open, laparoscopy or robot-assisted) represents the gold standard, while neoadjuvant and adjuvant chemotherapy or radiotherapy has a limited impact on overall survival. Since mucinous cystadenocarcinoma of urachal origin is a very uncommon pathological condition the differential diagnosis may be difficult and pathological investigations have to elucidate this disorder. It is worth mentioning the psychological impact on the patient in addition to the medical aspects. A rare condition is associated with heightened risk for mental health and psychosocial difficulties and this must be taken into account in the subsequent follow-up of the patient. In order to increase awareness of this rare entity we report a case of a 40-year-old male with a urachal adenocarcinoma who was treated surgically, with a favorable outcome. We also perform a brief literature review about this type of tumor.

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“…Young et al defined "giant umbilical cord" as diffuse enlargement of the umbilical cord beyond 5 cm in diameter in the second trimester and beyond, which is usually associated with vascular and urachal anomalies. 1 Although rare, umbilical cord abnormalities such as giant umbilical cord, which often persist into the perinatal period, are associated with congenital urogenital anomalies and an abnormal karyotype. Congenital abnormalities such as patent urachus is associated with a giant edematous umbilical cord secondary to significant pseudocyst formation.…”

Section: Introductionmentioning

confidence: 99%

Giant umbilical cord with impending heart failure—Prognostic significance of prenatal ultrasound

Ravikanth

2022

Sonography

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Detection of giant umbilical cord prenatally should lead to vigilant monitoring particularly at term as fetal demise is a possibility, as noted in the present case because of altered hemodynamics and related vascular complications such as compromised fetal circulation. A case of prenatally diagnosed, giant umbilical cord with fetoplacental insufficiency and impending heart failure is reported. An 18‐year‐old primigravida, presented at 34 weeks of gestational age with complaints of acute onset abdominal pain. Fetal umbilical artery obstetric Doppler examination demonstrated reversal of diastolic flow. 2D echocardiography demonstrated dilated all 4 chambers of the heart with reduced contractility suggesting impending heart failure. Subsequently, fetal demise was noted after 2 days, and labour was induced followed by vaginal delivery of the dead fetus. A giant umbilical cord was seen at delivery with absent knots or strictures. This case report deserves a special mention as there were no earlier reported cases of giant umbilical cord in literature presenting with impending heart failure and fetal demise. We have presented the detailed clinical course of the fetus with giant umbilical cord along with a review of the related literature.

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Management of the giant umbilical cord: challenging the need for investigations in the newborn

Cited by 10 publications

References 5 publications

Urachal Mucinous Cystic Tumor of Low Malignant Potential with Concurrent Sigmoid Colon Adenocarcinoma

Urachal Mucinous Cystic Tumor of Low Malignant Potential with Concurrent Sigmoid Colon Adenocarcinoma

Urachal Carcinoma, An Unusual Possibility of Hematuria; Case Report and Literature Review

Giant umbilical cord with impending heart failure—Prognostic significance of prenatal ultrasound

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