Urachal adenocarcinoma. Case report

Authors

DOI:

https://doi.org/10.48193/g0ck6874

Keywords:

Adenocarcinoma, urachus, bladder, hematuria

Abstract

Description: we present a 58-year-old man who came to the emergency room complaining of macroscopic hematuria. As a result of the diagnostic protocol, an extra-bladder tumor. A wide en bloc resection of the umbilical scar, middle umbilical ligament and bladder dome was performed. Diagnosis of poorly differentiated carcinoma of the peribladder soft tissues (urachus), T3 according to Sheldon's classification, surgical margins free of lesion, angiolymphatic invasion present. At 48-month follow-up, the patient remains negative for recurrence or metastasis.

Relevance: it is important to know the topic and make a differential diagnosis in patients who present with hematuria, as well as collaborate to compile evidence from similar clinical cases, in this way obtain greater knowledge of risk factors, with the subsequent preparation of detection protocols.

Clinical implications: urachal tumors constitute less than 1 % of bladder neoplasms, being a pathology of limited knowledge. A clinical case of urachal adenocarcinoma is presented, to provide evidence to the literature. 

Conclusions: the diagnosis of urachal adenocarcinoma is rarely considered in a patient with hematuria, and although its prevalence is low, it is important to promptly identify the disease to avoid complications and morbidity and mortality in our patients.

References

Cruz P, Ramírez M, Iborra I, Rubio J, Pinto F, Gómez-Ferrer A, et al. Adenocarcinoma de uraco: ¿qué tanto sabemos? Revista Mexicana de Urología. 2014;74(5): 301–307. https://doi.org/10.1016/j.uromx.2014.09.002.

Quan J, Pan X, Jin L, He T, Hu J, Shi B, et al. Urachal carcinoma: Report of two cases and review of the literature. Molecular and Clinical Oncology. 2017;6(1): 101–104. https://doi.org/10.3892/mco.2016.1082.

Szarvas T, Módos O, Niedworok C, Reis H, Szendröi A, Szász MA, et al. Clinical, prognostic, and therapeutic aspects of urachal carcinoma-A comprehensive review with meta-analysis of 1,010 cases. Urologic Oncology. 2016;34(9): 388–398. https://doi.org/10.1016/j.urolonc.2016.04.012.

Bruins HM, Visser O, Ploeg M, Hulsbergen-van de Kaa CA, Kiemeney LALM, Witjes JA. The clinical epidemiology of urachal carcinoma: results of a large, population based study. The Journal of Urology. 2012;188(4): 1102–1107. https://doi.org/10.1016/j.juro.2012.06.020.

Ashley RA, Inman BA, Sebo TJ, Leibovich BC, Blute ML, Kwon ED, et al. Urachal carcinoma: clinicopathologic features and long-term outcomes of an aggressive malignancy. Cancer. 2006;107(4): 712–720. https://doi.org/10.1002/cncr.22060.

García Salazar N, Pérez Silva MM, Acuña Hernández M, García Salazar N, Pérez Silva MM, Acuña Hernández M. Carcinoma de uraco, una neoplasia maligna poco frecuente. Revista Médica del Uruguay. 2018;34(1): 124–133. https://doi.org/10.29193/rmu.34.1.6.

Siefker-Radtke A. Urachal carcinoma: Surgical and chemotherapeutic options. Expert review of anticancer therapy. 2006;6(12): 1715–1721. https://doi.org/10.1586/14737140.6.12.1715.

Zeman M, Silver E, Akin EA. CT and PET findings for urachal adenocarcinoma: a case report. Annals of Clinical Case Reports. 2017;2. https://hsrc.himmelfarb.gwu.edu/smhs_rad_facpubs/216/

Gopalan A, Sharp DS, Fine SW, Tickoo SK, Herr HW, Reuter VE, et al. Urachal carcinoma: a clinicopathologic analysis of 24 cases with outcome correlation. The American Journal of Surgical Pathology. 2009;33(5): 659–668. https://doi.org/10.1097/PAS.0b013e31819aa4ae.

Sheldon CA, Clayman RV, Gonzalez R, Williams RD, Fraley EE. Malignant urachal lesions. The Journal of Urology. 1984;131(1): 1–8. https://doi.org/10.1016/s0022-5347(17)50167-6.

Herr HW, Bochner BH, Sharp D, Dalbagni G, Reuter VE. Urachal carcinoma: contemporary surgical outcomes. The Journal of Urology. 2007;178(1): 74–78; discussion 78. https://doi.org/10.1016/j.juro.2007.03.022.

Limonnik V, Samiei A, Abel S, Wegner RE, Vemana G, Mao SS. Urachal carcinoma: A novel staging system utilizing the National Cancer Database. Cancer Medicine. 2023;12(3): 2752–2760. https://doi.org/10.1002/cam4.5164.

Pinthus JH, Haddad R, Trachtenberg J, Holowaty E, Bowler J, Herzenberg AM, et al. Population based survival data on urachal tumors. The Journal of Urology. 2006;175(6): 2042–2047; discussion 2047. https://doi.org/10.1016/S0022-5347(06)00263-1.

Mylonas KS, O Malley P, Ziogas IA, El-Kabab L, Nasioudis D. Malignant urachal neoplasms: A population-based study and systematic review of literature. Urologic Oncology. 2017;35(1): 33.e11-33.e19. https://doi.org/10.1016/j.urolonc.2016.07.021.

Yu YD, Ko YH, Kim JW, Jung SI, Kang SH, Park J, et al. The Prognosis and Oncological Predictor of Urachal Carcinoma of the Bladder: A Large Scale Multicenter Cohort Study Analyzed 203 Patients With Long Term Follow-Up. Frontiers in Oncology. 2021;11. https://doi.org/10.3389/fonc.2021.683190.

Song SH, Lee J, Ko YH, Kim JW, Jung SI, Kang SH, et al. TNM-Based Head-to-Head Comparison of Urachal Carcinoma and Urothelial Bladder Cancer: Stage-Matched Analysis of a Large Multicenter National Cohort. Cancer Research and Treatment : Official Journal of Korean Cancer Association. 2023;55(4): 1337–1345. https://doi.org/10.4143/crt.2023.417.

Siefker-Radtke A. Urachal adenocarcinoma: a clinician’s guide for treatment. Seminars in Oncology. 2012;39(5): 619–624. https://doi.org/10.1053/j.seminoncol.2012.08.011.

Ke C, Xu L, Wang M, Wang Y, Zhou Q, Chen J, et al. Treatment options and prognostic risk factors for urachal carcinoma: A multicetnter retrospective study. Urologic Oncology. 2023;41(1): 50.e1-50.e9. https://doi.org/10.1016/j.urolonc.2022.09.017.

Downloads

Published

2025-05-19

Issue

Section

Clinical cases