urachal carcinoma

urachal carcinoma

A malignancy which arises in the dome of the urinary bladder, the site of the embryonic urachus; it comprises up to one-third of bladder adenocarcinomas; most cases present as stage T3a or higher.

Epidemiology
Mean age, 52 to 55; slight male predominance.
 
Clinical findings
Haematuria, mass, urinary-tract infections.

Management
Early and complete extended partial cystectomy with umbilectomy offers best chance for long-term survival.

Prognosis
29% local recurrence, especially those who undergo partial cystectomy; over 1/3 metastasise; 1/3 die of disease; 50% five-year survival.
References in periodicals archive ?
Urachal carcinoma: a clinicopathologic analysis of 24 cases with outcome correlation.
Witjes, "The clinical epidemiology of urachal carcinoma: results of a large, population based study," The Journal of Urology, vol.
Urachal carcinoma is a rare malignant tumor, accounting for fewer than 1% of all primary bladder cancers [1].
We report a case of 46-year-old woman with an urachal carcinoma and do a brief literature review about this extremely rare entity.
The location and histological type of the mass suggested that it arose from the urachal remnant, and it was diagnosed as urachal carcinoma. This tumor was located in the abdominal wall at a distance from the bladder, where no malignant tissue was seen.
Characteristic imaging features, however, proved decisive in establishing the diagnosis of a urachal carcinoma.
Mucinous Ovarian Versus Mucinous Urachal Adenocarcinoma.--A differentiating panel includes [beta]-catenin (-), CDX-2 (- or +), CK 7 (+), and CK20 (+ or -, patchy) for mucinous ovarian carcinomas, whereas metastatic urachal carcinoma displays the following pattern: [beta]-catenin (+), CDX-2 (+), CK7 (- or +, patchy), and CK20 (+).
Diffuse positivity for 34[beta]E12 may support a diagnosis of urachal carcinoma, while diffuse nuclear staining for [beta]-catenin would favor a colorectal origin.
Urachal carcinoma is a less common tumor that can present as a bladder mass and should be considered in the list of differential diagnoses.
Columnar cells with malignant features may arise from high-grade transitional cell carcinoma, urachal carcinoma, or prostatic carcinoma.