Signet Ring Cell Carcinoma of Urachal Origin Presenting as Irritative Lower Urinary Tract Symptoms and Pain Abdomen: A Rare Case Report

Abstract

A 61-year-old male, non smoker presented to our hospital with pain lower abdomen, increased frequency of urination (about 15 times during day and 6 times during the night) and urgency of urination for last 6 months. His pain was dull, continuous, non colicky, non radiating and had no relation to food intake. There was no history of weight loss.On physical examination, a well defined lump was palpable in the umbilical and hypogastic region, globular in shape, of approximate size 6×5cm, had smooth surface and regular margins all around. The rest of the physical examination was absolutely normal. Ultrasonography showed a solid heterogenous mass of size about 10×5cm above urinary bladder. Urine microscopy and urine cytology were absolutely normal. Computed Tomography (CT) of the abdomen showed a hypodense soft tissue density lesion of size 9×5×6cm in supravesical region with obliterated fat planes from the dome of urinary bladder and the lesion extended superiorly up to just below the umbilicus [Table/ Fig-1 Signet ring cell carcinoma of urachus is a very rare tumour. It generally presents as a high grade, high stage tumour and in most of the cases it has regional or distant metastasis at the time of presentation. It is known to have a uniformly poor prognosis. We present here a very interesting and rare case report of signet ring cell carcinoma of urachus in a 61-year-old male who presented with irritative lower urinary tract symptoms and pain abdomen. High index of suspicion led to the early diagnosis and timely surgical intervention. The patient is doing well on follow-up.

Primary signet-ring cell carcinoma of the urinary bladder

“…Therefore, primary urachal adenocarcinoma with isolated signet-ring cell differentiation is very rare and was not considered in this case. 17,18 As there is no consensus guideline for the management of PSRCC, input from the diagnostic and related clinical subspecialties are required in a multidisciplinary setting. PSRCCs are uniformly insensitive to radiotherapy and standard chemotherapy.…”

Primary urachal adenocarcinoma: a rare case report

“…Generally, URC presents as a high-grade, high-stage cancer, and in the majority of cases there is regional or distant metastasis at the time of presentation. Therefore, this cancer is usually associated with a poor prognosis [12] . By lymphatic dissemination URC usually metastasizes into the pelvic lymph nodes and by hematogenous dissemination into distant organs, especially lungs, bone, or peritoneum [13] .…”

Primary urachal signet ring cell carcinoma: A case report

“…Signet ring cell carcinoma is a subtype of urachal adenocarcinoma and only accounts for 7% ( 3 ). A few cases regarding urachal signet ring cell carcinoma have been reported ( 4 – 13 ). In the current study, one additional case in a 49-year-old male patient was reported, and a literature review was conducted to strengthen the cognition of urachal carcinoma.…”