Urachal adenocarcinoma: a rare case report

Abstract

Urachal carcinoma is a rare and aggressive form of bladder cancer involving the urachus, a fibrous remnant of the allantois that extends from the bladder to the umbilicus. We report this case of a 49-year-old women with primary urachal adenocarcinoma treated with partial cystectomy who relapsed 5 years after surgery with lung metastases. This patient with unremarkable medical history presented with abdominal discomfort and a palpable pelvic mass. Follow-up imaging reveals a large mass on the dome of the bladder extending from the urachus. Subsequent ultrasound-guided biopsy result was suggestive of an urachal mucinous adenocarcinoma. The patient was treated surgically with a partial cystectomy.

Urachal Adenocarcinoma: A Case Report with Key Imaging Findings and Radiologic-Pathologic Correlation

“…UrC accounts for 0.01% of all cancers in adults [ 1 ]. It was originally described by Hue and Jacquin in 1963 and it has a male predilection, with a mean age of presentation of 60 years (ranging from 40 to 70) [ 4 , 5 ].…”

“…Urachal cancer (UrC) is an uncommon neoplasm, representing 0.5–2% of all bladder cancer. Although transitional epithelium usually lines the urachus, most urachal tumors are adenocarcinomas (90%) and represent 20%–40% of all primary bladder adenocarcinomas [ 1 ]. Despite being such rare entities, the number of publications regarding UrC has increased from 3 (between 1980 and 2005) to 10 cases per year on the last decade [ 2 ].…”

Wide excision and reconstruction surgery for recurrent sweat gland umbilical adenocarcinoma followed by chemotherapy can prevent the risk of recurrences

“…In some cases, an irregular hypoechoic mass can be found with microcalcification in the umbilical region, but not extending into the peritoneal cavity [1]. Doppler imaging sometimes can show internal vascularity [8]. Local staging and evaluation of distant metastases of the tumor often uses CT scan and MRI.…”

Urachal adenocarcinoma

“…First described in 1963 by Hue and Jacquin, this condition has a male predilection and a mean age of presentation of 50-60 years. 1 The urachus originates from the involution of the allantois and cloaca, as an embryonic remnant, extending from the umbilicus to the bladder dome. Although it involutes with age, its patency may persist in a minor proportion of adults.…”

“…Haematuria is the most common presentation. 1 The criteria for pathological diagnosis of UC according to WHO 2016 include the following: (1) tumour localised in the dome/anterior wall; images in… (2) carcinoma epicentre in the bladder wall; (3) absence of cystitis/glandularis beyond the dome/anterior wall; (4) absence of urothelial neoplasia in the bladder (5) and absence of a known primary tumour elsewhere. 2 IHC plays a pivotal role in differentiating primary UC from secondary ones.…”