Urachal adenocarcinoma – case report and literature review

Milan Petrović; Vladimir Vasić; Ljubinka Janković-Veličković; Srdjan Šterović; Tomislav Pejčić; Jovan Hadži-Djokić

doi:10.2298/VSP160827009P

Milan Petrović General Hospital Leskovac, Department of Urology, Leskovac, Serbia
Vladimir Vasić Polyclinic “Drašković”, Belgrade, Serbia
Ljubinka Janković-Veličković Faculty of Medicine, Institute of Pathology, Niš, Serbia
Srdjan Šterović General Hospital Leskovac, Department of Urology, Leskovac, Serbia
Tomislav Pejčić Clinical Center of Serbia, Urological Clinic, Belgrade, Serbia
Jovan Hadži-Djokić Serbian Academy of Sciences and Arts, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP160827009P

Keywords: urachus;, adenocarcinoma;, urinary bladder;, diagnostic techniques and procedures;, urologic surgical procedures.

Abstract

Introduction. Urachal adenocarcinoma is extremely rare and comprises from 0.35% to 0.7% of all bladder tumors. The most common histologic subtype of urachal tumors is adenocarcinoma which can be associated with intestinal metaplasia and mucin production. Case report. We report a case of a 53-year-old patient who attented a urologist because of an intermittent haematuria lasting for three months. The ultrasound examination detected infiltration of the bladder at the fundus, 24 × 29 mm in diameter. By the same wall, next to the tumor, there was an oval hypoechoic lesion about 40 mm in diameter. Computed tomography scan showed a solid, echogenic, strictly limited tumor at the fundus of the bladder, anteriorly, 32 × 35 × 22 mm in diameter which was positive after contrast application. The patient underwent partial cystectomy with complete excision of the tumor lesion 1.5 cm in healthy tissue. Histopathological analysis showed diagnosis of Adenocarcinoma mucinosum vesicae urinariae infiltrans. Patohistological findings detected a part of the urachal wall with a thin layer of fibromuscular tissue, chronic inflammation, microcalcifications in the lumen, flattened and desquamated epithelium. One year after the surgery, there were no signs of primary disease or metastases in other organs. Conclusion. Urachal adenocarcinoma is extremely rare. Long term survival could be achieved by surgical treatment in the early stage of the disease which consists of complete resection of urachal carcinoma and partial or total cystectomy.

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