Chondrosarcoma is a rare complication in hereditary multiple exostoses. The six patients in this study have had a complete follow-up and constitute the largest group of such cases to have been studied so far. Five patients had histologic evidence of malignancy. Since histologic examination can be very difficult, any other diagnostic features, may it be clinical, radiologic, or scintigraphical, should be taken into account for early surgical treatment. Bone scintigraphic examination is a valuable adjunct to early diagnosis of malignant change by showing highest uptake in malignant areas. It is also very useful for posttherapeutic follow-up.

Although 1 in 5,000 autopsies in children reveal urachal this is an infrequent problem in adults. Our review of the radiological literature revealed three reports of urachal cysts in adulthood: one ultrasound3 and two computed tomographic detection^.^ Other radiological evaluations of urachal anomalies are reported: one urachal cyst in a n infant5 and one urachal carcinoma6 have been identified with ultrasound; two urachal carcinomas' have also been detected by computed tomography. We recently discovered a case of urachal cyst in a woman referred for a vague abdominal pain which was diagnosed as a result of a n ultrasound examination. CASE REPORTA 36-year-old woman (gravida 3, para 3, abortus 0) was admitted for sonographic evaluation of a right-sided abdominal pain below the umbilicus which had been present for several months. She had been treated for several infectious cystic diseases and renal calculus 3 months prior to admission. She had had tuberculosis infection as a child. She had no other symptom related to the gastro-intestinal or genito-urinary tract, but she was febrile with a temperature of 38.5"C. There is no history of trauma. Physical examination demonstrated diffuse lower abdominal tenderness without a peritoneal sign; the appearance of the umbilicus was normal. The white blood cell count was ll,000/mm3 with 53% neutrophils, 12% bands, and 35% lymphocytes. The remainder of 48the hemogram and the routine serum chemistries were normal. Urinalysis and urine cultures were negative.Oblique longitudinal echographic section ( Fig. 1) showed an echofree tubular structure in the lower midanterior abdominal wall; its upper pole lay a t the level of the umbilicus and the duct extended to the bladder. No continuity of the bladder with the tubular structure could be seen. Low abdominal transverse sections (Fig. 3) showed a 2-cm diameter cyst posterior to the rectus muscle and located to the right. A postvoid ultrasonic examination later showed that the lesion had remained unchanged in size and shape. A cystogram showed the bladder to be large but no contrast material entered the lesion shown ultrasonically. The findings were interpreted as representing a n urachal cyst without an opening into the umbilicus or bladder.Laparotomy confirmed the diagnosis and the patient was subsequently explored surgically. A 12-cm-long extraperitoneal cystic mass was found adherent to the right of the lower midanterior wall. The central part was dilated to 2 cm diameter and contained a cavity without pus. This urachal cyst, without an opening into the umbilicus and clearly separated from the bladder, was excised. The patient did well postoperatively. DISCUSSIONThe fetal urinary bladder develops from the anterior part of the common cloaca. It extends to the umbilicus and is continuous with the allantois. Normally the superior portion regresses and contracts into a cordlike structure, the urachus, while the inferior part becomes the bladder.' After birth the normal urachus is a 3-to 5 cm-long fibrous cord which is extraperitonea...

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