Surgical treatment, such as mass excision, urachectomy, or urachectomy combined with partial cystectomy, is the first-line and definitive treatment for mucinous cystadenomas of the
urachus. All 9 reported patients with mucinous cystadenoma survived the tumor without evidence of recurrence for up to 97 months of follow-up.
In our case, the presence of a midline cavity, anterosuperior to the bladder dome, filled with low attenuation fluid, suggested adenocarcinoma of the
urachus as the main diagnosis.
Similarly, the total number of reported cases of UL RMS in pediatric patients, either in the obliterated umbilical arteries (medial UL) or in
urachus (median UL), is 17 including these 2 new cases (Table 3) [5, 7-9, 24-31].
The
urachus carcinoma accounts for <1% of all bladder cancers [2, 3].
Glandular tumours of the
urachus remain sparsely described due to rarity, degree of clinical correlation required to establish urachal origin, and lack of standardized nomenclature.
(1,2) The most likely site of origin is the appendix, though other primary sites include the large and small bowels, stomach, bile ducts, gallbladder, pancreas, ovary, fallopian tubes,
urachus, urinary bladder, breast, and lung.
Direct extension along the ligaments of embryonic origin have been described including the round ligament of the liver, the
urachus, the vittelointestinal duct remnant, and the obliterated vitelline artery.
This infection may occur soon after the birth and may also result in omphalitis omphalophlebitis omphaloarteritis or urachitis of the
urachus (Ganga that become source of navel infection include when an umbilical cord is cut at a level very close to abdominal wall of calf poor navel hygiene practices and unfavorable environmental conditions such as parturition of cow in unhygienic calving pens inadequate colostrum feeding within six hours after calving or having the umbilical stump sucked on by other calves if newborn calf is mixed with other calves after calving (Smith 2003).
Applying Caris Molecular Intelligence's multi-technology approach, including immunohistochemistry (IHC), in situ hybridization (ISH), and gene sequencing (next-generation and Sanger sequencing) analysis, 592 locally advanced or metastatic UC tumours were studied, out of which 463 (87.5%) were cases of bladder UC, 74 (12.5%) of non-bladder UC (renal pelvis, ureter,
urachus, urethra), and 55 were other histotypes (27 adenocarcinomas, 17 squamous cell carcinomas, 11 small cell carcinomas).
The median umbilical fold, which is the peritoneal covering of the umbilical ligament/
urachus, travels between the bladder and umbilicus in the midline anterior abdominal wall.
(4) Other rare sources of PMP include malignancy of the colon (see Figures 3 and 4), stomach, uterus, pancreas, gallbladder, common bile duct and
urachus (see Figure 5).