Uterine perforation simulating urachal carcinoma: CT diagnosis.

Urachal neoplasms are characterized by their typical location in the midline position within the space of Retzius and their predominant extravesical extension. Prognosis is poor and differentiation from other neoplasms and nonneoplastic processes is important for determining both prognosis and treatment. Entities such as infected urachal cysts and primary bladder carcinomas arising in the apex occasionally have a similar appearance. In addition, ovarian and gastrointestinal neoplasms, as well as inflammatory gastrointestinal masses from Crohn disease or diverticulitis, can rarely occur in this location. This case illustrates how an inflammatory mass resulting from uterine perforation can simulate a urachal neoplasm and, in patients with known uterine manipulation, must be included in the differential diagnosis of vesical dome masses.