Abstract
Urachal adenocarcinoma is one of the rare and aggressive neoplasms that often presents at an advanced stage and has a poor prognosis. Urachal adenocarcinoma makes up 0.17 to 0.34% of all bladder carcinomas. Patients commonly present with hematuria. Wide local excision of urachal mass with umbilicus and surrounding soft tissue en bloc combined with partial or radical cystectomy and bilateral pelvic lymphadenectomy is considered to be the primary surgical management. However, many publications in literature report that en bloc removal of tumor with umbilicus, entire urachal ligament, and bladder dome alone has long-term survival and disease-free period. Here, we present a case of a 50-year-old post-menopausal female patient with a fungating mass in the umbilical region of size approximately 10 cm in maximum diameter with mucopurulent discharge from the mass. The patient had no history of any hematuria, mucinuria, burning micturition, or any particles in urine. A laparotomy was performed, and tumor mass along with the cuff of the bladder dome was removed as en bloc along with umbilectomy. This case report highlights a rare case of urachal adenocarcinoma with a fungating mass of large size in a female patient which is otherwise more commonly seen in males. A review of published literature is also presented.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sheldon CA, Clayman RV, Gonzalez R, Williams RD, Fraley EE (1984) Malignant urachal lesions. J Urol 131:1–8. https://doi.org/10.1016/S0022-5347(17)50167-6
Begg RC (1930) The urachus: its anatomy, histology and development. J Anat 64:170–183
Schubert GE, Pavkovic MB, Bethke-Bedurftig BA (1982) Tubular urachal remnants in adult bladders. J Urol 127:40–42. https://doi.org/10.1016/S0022-5347(17)53595-8
Tian J, Ma JH, Li CL, Xiao ZD (2008) Urachal mass in adults: clinical analysis of 33 cases. Zhonghua Yi Xue Za Zhi 88:820–822
Herr HW, Bochner BH, Sharp D, Dalbagni G, Reuter VE (2007) Urachal carcinoma: contemporary surgical outcomes. J Urol 178:74–78. https://doi.org/10.1016/j.juro.2007.03.022
Grignon DJ, Ro JY, Ayala AG et al (1991) Primary adenocarcinoma of the urinary bladder. A clinicopathologic analysis of 72 cases. Cancer 67:2165–2172. https://doi.org/10.1002/1097-0142(19910415)67:8<2165::AID-CNCR2820670827>3.0.CO;2-M
Siefker-Radtke AO, Gee J, Shen Y et al (2003) Multimodality management of urachal carcinoma: the M. D. Anderson Cancer Center experience J Urol 169:1295–1298. https://doi.org/10.1097/01.ju.0000054646.49381.01
Mostofi FK, Thomson RV, Dean AL Jr (1955) Mucous adenocarcinoma of the urinary bladder. Cancer 8:741–758. https://doi.org/10.1002/1097-0142(1955)8:4<741::AID-CNCR2820080417>3.0.CO;2-C
Bauer SB, Retik AB (1978) Urachal anomalies and related umbilical disorders. Urol Clin North Am 5:195–211
Scheye T, Vanneuville G, Amara B, Francannet P, Dechelotte P, Campagne D (1994) Anatomic basis of pathology of the urachus. Surg Radiol Anat 16:135–241. https://doi.org/10.1007/BF01627586
Nix J, Menville J, Albert M, Wendt D (1958) Congenital patent urachus. J Urol 79:264–273. https://doi.org/10.1016/S0022-5347(17)66268-2
Mesrobian HG, Zacharias A, Balcom AH, Cohen RD (1997) Ten years of experience with isolated urachal anomalies in children. J Urol 158:1316–1318. https://doi.org/10.1016/S0022-5347(01)64465-3
Siefker-Radtke A (2006) Urachal carcinoma: surgical and chemotherapeutic options. Expert Rev Anticancer Ther 6:1715–1721. https://doi.org/10.1586/14737140.6.12.1715
Sharma P, Eigbire G, Sharma R (2021) Small bowel obstruction due to metastatic urachal adenocarcinoma: a rare presentation. Cureus 13:e19705. https://doi.org/10.7759/cureus.19705
Ashley RA, Inman BA, Sebo TJ et al (2006) Urachal carcinoma: clinicopathologic features and long-term outcomes of an aggressive malignancy. Cancer 107:712–720. https://doi.org/10.1002/cncr.22060
Creffier C, Broome K, Palmer D (2021) Ovarian metastasis from a urachal adenocarcinoma primary in a young female. Urol Case Rep 39:101797. https://doi.org/10.1016/j.eucr.2021.101797
Van Allen J (2021) A rare case of urachal adenocarcinoma with bone marrow metastasis. BMJ Case Rep 14:e242315. https://doi.org/10.1136/bcr-2021-242315
Zhou MH, Wang ZH, Zhou HW et al (2018) Clinical outcome of 30 patients with bone marrow metastases. J Cancer Res Ther 14:512–515. https://doi.org/10.4103/0973-1482.172717
Wheeler JD, Hill WT (1954) Adenocarcinoma involving the urinary bladder. Cancer 7:119–135. https://doi.org/10.1002/1097-0142(195401)7:1<119::AID-CNCR2820070113>3.0.CO;2-8
Singh I, Prasad R (2013) Primary urachal mucinous adenocarcinoma of the urinary bladder. J Clin Diagn Res 7:911–913. https://doi.org/10.7860/jcdr/2013/5597.2973
Reis H, Krafft U, Niedworok C, Módos O, Herold T, Behrendt M et al (2018) Biomarkers in urachal cancer and adenocarcinomas in the bladder: a comprehensive review supplemented by own data. Dis Markers 2018:7308168. https://doi.org/10.1155/2018/7308168
Gural Z, Yücel S, Oskeroğlu S, Ağaoğlu F (2022) Urachal adenocarcinoma: a case report and review of the literature. J Cancer Res Ther 18:291–293. https://doi.org/10.4103/jcrt.jcrt_28_20
Hamilou Z, North S, Canil C, Wood L, Hotte S, Sridhar SS et al (2020) Management of urachal cancer: a consensus statement by the Canadian Urological Association and Genitourinary Medical Oncologists of Canada. Can Urol Assoc J 14:E57–E64. https://doi.org/10.5489/cuaj.5946
Pinthus JH et al (2006) Population based survival data on urachal tumors. J Urol 175:2042–2047. https://doi.org/10.1016/s0022-5347(06)00263-1
Hong SH, Kim JC, Hwang TK et al (2007) Laparoscopic partial cystectomy with en bloc resection of the urachus for urachal adenocarcinoma. Int J Urol 14:963–965. https://doi.org/10.1111/j.1442-2042.2007.01855.x
Author information
Authors and Affiliations
Contributions
All authors have contributed to the study conception and design. All authors have contributed equally to the drafting of the manuscript, critical revision, and final approval of the manuscript.
Corresponding author
Ethics declarations
Ethics Approval
Not applicable
Consent to Participate
Informed consent was obtained from the participant included in the study. Patient details have not been disclosed in any form in our case report.
Consent for Publication
The participant has consented to the submission of the case report to the journal. Patient details have not been disclosed in any form in our case report.
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Chejara, R., Goyal, S., Choudhary, S. et al. Urachal Adenocarcinoma: a Case Report and Review of the Literature. Indian J Surg Oncol 14, 677–681 (2023). https://doi.org/10.1007/s13193-023-01736-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13193-023-01736-6