Abstract
A 72-year-old man who visited a neighboring hospital because of a one-week history of lower abdominal pain and dysuria was found to have tumor at the cranial side of the urinary bladder on an abdominal simple CT scan. The patient was referred to our hospital for further examinations and treatment. Blood analysis revealed increases in the WBC count and CRP level. Abdominal contrast-enhanced CT scan showed wall thickening at the top of the urinary bladder and a tumor which continued to the umbilicus right under the midline abdominal wall. Urachal cancer was suspected from the imaging findings, but we identified a linear shadow suggestive of a fish bone within the tumor and pyuria which was noted after admission. Accordingly administration of antibiotics was started, that resulted in an improving tendency in blood and urine findings. Abdominal CT scan revealed shrinkage of the tumor and the linear shadow which had been seen within the tumor moved to the urethra. Cystoscopy confirmed a fish bone stabbed in the prostate. The fish bone was removed through the urethra. The antibiotics therapy was maintained and the tumor completely disappeared. The tumor was thus considered to be perivesical abscess due to the fish bone.
It was difficult to differentiate from urachal disease, but we could accomplish the conservative therapy in the patient due to a rare clinical course. We present this case, together with a review of the literature.
