Unrecognized urinoma caused by infiltrative bladder cancer

Dragan Grbić; Dimitrije P. Jeremić; Saša Vojinov; Ivan Levakov; Alexander B. Cantrell; Goran Marušić

doi:10.2298/VSP161230036G

Dragan Grbić Clinical Center of Vojvodina, Department of Urology, Novi Sad, Serbia
Dimitrije P. Jeremić Clinical Center of Vojvodina, Department of Urology, Novi Sad, Serbia
Saša Vojinov Clinical Center of Vojvodina, Department of Urology, Novi Sad, Serbia
Ivan Levakov Clinical Center of Vojvodina, Department of Urology, Novi Sad, Serbia
Alexander B. Cantrell University of California, Department of Urology, Davis, United States
Goran Marušić Clinical Center of Vojvodina, Department of Urology, Novi Sad, Serbia

DOI: https://doi.org/10.2298/VSP161230036G

Keywords: urinoma;, diagnosis;, tomography, x-ray computed;, histological techniques;, urinary bladder, neoplasms.

Abstract

Introduction. Urinoma develops after disruption of collecting system of urinary tract and urine leak in surrounding tissue. Most common causes of urinoma are blunt or penetrating trauma. Less common causes are iatrogenic injuries or urinary tract obstruction. In this article we presented a rare case of the urinoma caused by infiltrative bladder cancer. Case report. Acutely ill, a septic patient with ileus and profound azothaemia was admitted to medical intensive care unit. Native computed tomography revealed moderate ileus, right kidney hydronephrosis, extensive retroperitoneal urinoma and vesical thickening with excluded infiltration of ureteral orifices. Computed tomography guided percutaneous drainage was done. Upon stabilization, patient underwent transurethral bladder tumor electroresection (histopathology report was: infiltrative transitional cell tumor of urinary bladder). Radical cystectomy was done. The patient’s recovery was uneventful. Conclusion. Urinoma formed due to spontaneous rupture of collecting system based on ureteral obstruction caused by urinary bladder tumor is very rare clinical case scenario. In case of urinoma of unclear etiology invasive bladder cancer should be excluded.

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