Age / Sex : 70 / F
Chief complaint : Urinary obstruction and intermittent urinary incontinence.
What is your diagnosis?
Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).
Courtesy : 장민영, Min-Yung Chang, 국민건강보험공단 일산병원, National Health Insurance Service Ilsan hospital
Diagnosis: Subpubic cartilaginous cyst = suprapubic cartilaginous cyst = retropubic cartilaginous cyst
Discussion
Findings:
Round cystic mass which had a broad interface with the symphysis
Neurogenic bladder
Differential Diagnosis:
None
Discussion:
- pubic symphysis : a nonsynovial amphiarthrodial joint that is situated at the confluence of the two pubic bones. The joint is composed of a thick fibrocartilaginous disk sandwiched between thin layers of hyaline cartilage. The pubic symphysis is reinforced by four strong ligaments; inferior pubic (or subpubic or arcuate) ligament, superior, anterior, and posterior pubic ligaments.
- Subcartilaginous cyst
- rare cystic lesions arising from the symphysis pubis thought to be degenerative in origin.
- epidemiology : multiparous and post-menopausal women.
- Asymptomatic or urinary voiding symptoms, pelvic pain…
- pathology : they consist of a dense fibrocartilaginous capsule internally covered by a thin layer of degenerate fibrocartilage. The lumen is filled with acellular debris and further degenerate fibrocartilage with mucin deposits
- cystic, ganglionlike mucinous degeneration of the arcuate ligament tissue with cartilaginous metaplasia?
References:
- Alguacil-Garcia A, Littman CD. Subpubic Cartilaginous Cyst: Report of Two Cases. The American Journal of Surgical Pathology 1996; 20
- Kim CE, Beasley HS. MRI Diagnosis of Subpubic Cartilaginous Cyst. American Journal of Roentgenology 2004; 182:144-146
- Price G, McNicholas T, Buckingham S, Chang S. Subpubic cartilaginous cyst: an unusual cause of urinary tract infection. JRSM Open 2018; 9:2054270417739779
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