Urachal adenocarcinoma surgical management – Emphasis on enbloc umbilectomy and urachal remnant excision with negative margins

Abstract

Urachal adenocarcinoma is a rare malignant epithelial cancer. It usually presents in advanced stages. We present a 35-year-old female with urachal adenocarcinoma presented with an anterior abdominal wall swelling and ulcer managed surgically with wide excision of anterior abdominal wall along with intra-abdominal tumour mass with umbilectomy and contiguous urachal remnant excision with abdominal wall reconstruction with mesh repair who was doing well at one year follow up. We also present a brief review regarding pathologic criteria, evolution of various staging systems and surgical aspects of urachal adenocarcinoma.

Umbilical sparing robotic partial cystectomy for localized urachal adenocarcinoma: A case report

“…Historically, radical cystectomy with pelvic lymph node dissection was considered the optimal treatment for urachal adenocarcinoma. 2 Today, increased understanding of the embryologic origin of the tumor with concurrent advances in surgical technique have allowed partial cystectomy to become the gold standard of surgical treatment for patients with urachal adenocarcinoma with the largest, most recent series showing no significant difference in survival between partial vs. radical cystectomy. 1 , 2 …”

“…Negative surgical margin is the most important prognostic marker. 2 Historically, en bloc umbilectomy with urachal remnant excision has been advocated. However, we present a case of umbilicus sparing robotic partial cystectomy and urachal excision for a small incidentally discovered urachal adenocarcinoma located at the bladder dome.…”