A rare cause of palpable mass located at the suprapubic area: abscess of omphalomesenteric duct cyst.

A 49–year-old female admitted to our unit with fever, lower midabdominal pain and a palpable mass. Her medical history revealed that she underwent cesarean section 15 years before. She had hypertension, asthma and moderate mitral valve stenosis. On physical examination, axillary body temperature was 38.3°C, blood pressure: 140/80 mmHg and heart rate: 110/min. Lower abdominal quadrants were tender. White blood cell count was 15300 mm and C-reactive protein level was 70 U/ml. Ultrasonography demonstrated a hypoechoic cystic lesion localized at the anterosuperior part of the bladder. Computed tomography showed a 6x2 cm lesion, located between the anterior wall of the bladder and the abdominal wall, below the umbilicus (Figure 1a). Fine needle aspiration was performed and leukocytes, gram-positive diplococci and gram-negative bacilli were seen on microscopic evaluation. In the surgical exploration, the cystic lesion was seen under the abdominal wall and there was no attachment to other intraabdominal organs. Total cystectomy was performed later (Figure 1b). The abscess culture grew Pseudomonas spp. Ciprofloxacin 500 mg tablets per oral twice a day was initiated. The wall of the cyst was composed of a wide smooth muscle layer and mucinous prismatic intestinal epithelium resembling bile duct epithelium (Figure 1c). Omphalomesenteric cyst was diagnosed in light of these histopathologic findings. The patient recovered uneventfully after the operation.