Multiple cystic lesions in the abdominopelvic cavity one and a half years after resection of presacral neurogenic tumor: tumor recurrence or other?
Keywords:Urinoma, Neurogenic neoplasia, Presacral surgery, Retroperitoneal surgery, Spontaneous rupture of ureter
Cystic lesions of abdominopelvic cavity include a variety of pathologies and diagnosis can sometimes be challenging. Urinoma can be caused by iatrogenic injury, spontaneous rupture of ureters or by various causes of ureteral obstruction. It needs to be differentiated from abdominopelvic cystic diseases including tumors that can undergo cystic degeneration. Here we report a case of a 41 years old female underwent a presacral neurogenic tumor resection at a local hospital 5 years ago. The tumor recurred three and a half years after the first surgery and removed at another hospital. She experienced abdominal distension and difficulty in urination from the last 2 months and was diagnosed as having a recurrence of tumor once again at both hospitals on separate CT scans. They believed that the tumor was too large and encroaching on adjacent organs to be surgically resected, she was finally diagnosed as infected urinoma during surgery in our hospital. Even though spontaneous rupture of ureters and urinoma formation is a rare disease but it should be considered as a main differential diagnosis of recurrence of neurogenic tumors especially in post abdominopelvic surgeries patient.
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