Urachal Adenocarcinoma Metastatic to the Ovaries: Case Report and Literature Review

Abstract

We report a urachal adenocarcinoma metastatic to both ovaries in a 50-year-old Japanese woman. Pelvic examination and imaging studies revealed a large cystic tumor occupying the pelvis and another cystic tumor between the umbilicus and the urinary bladder. A laparotomy was performed. Histopathological examination revealed a urachal tumor that was a well-differentiated invasive mucinous adenocarcinoma; the overlying urothelium was intact. The right and left ovarian tumors were well-differentiated mucinous adenocarcinomas. The urachal and ovarian tumors were immunoreactive for cytokeratin 20 and carcinoembryonic antigen, but negative for cytokeratin 7. The patient is alive with lymph node and bone metastases 6 months postoperatively. This is the eighth reported case of an adenocarcinoma of the bladder with ovarian metastasis.

Umbilical metastasis (Sister Joseph's nodule) as a first sign of a disseminated ovarian carcinoma: comparative immunohistochemical analysis of primary tumor and its metastases

“…In our case, the presence of tumor nests on the peritoneal surface and in numerous lymphatic channels indicates that more than one mechanism could be involved in a single patient. The absence of neoplastic changes in mucosa of the colon and the endometrium and the immunohistochemical profile exclude other possible sites of origin of umbilical metastasis, including the exceptional urachal adenocarcinoma metastatic to the ovary which is positive for cytokeratin 20 and negative for cytokeratin 7 (9) . The absence of membranous beta-catenin staining could indicate abnormalities in adhesion between tumor cells with pronounced invasive capability, and differences in expression pattern between central and peripheral tumor parts were recently described in colonic carcinoma and its metastases (10) as well as in poorly differentiated (but not well differentiated) neu-roendocrine carcinomas of the gastrointestinal tract (11) .…”

Partial Cystectomy with Robot Assisted Surgery in the Treatment of Urachal Adenocarcinoma of Bladder: Case Report

“…Daha az sıklıkla karın ağrısı, suprapubik kitle ve umbilikustan kan gelmesi şikâyetleri görülmektedir. 6 Urakal adenokarsinomlar bazen kalsifiye olabilmekte ve direkt üriner sistem grafisinde de görü-lebilmektedir. Renkli Doppler USG'de umbilikus etrafında neovaskülarizasyon görülebilmektedir.…”

Urachal papillary cystadenocarcinoma: A rare case report

“…Rarely, urachal adenocarcinomas can have a signet ring pattern. [7][8][9] Immunohistochemically, these tumors are positive for CK20 and can show variable positivity for CK7 and 34BE12. [10] Immunostains do not unequivocally discriminate a urachal from a colorectal carcinoma, but diffuse positivity for 34BE12 would support, and diffuse nuclear immunoreactivity for -catenin would militate against, a diagnosis of urachal carcinoma.…”