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 ?
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 (+).
Characteristic imaging features, however, proved decisive in establishing the diagnosis of a urachal carcinoma.
Patients with urachal carcinoma present with haematuria, dysuria, abdominal pain, umbilical mass or bloody, mucoid discharge.
Haematuria is the most common presenting symptom in both urachal carcinoma and primary malignancy of the bladder.
Similarly to our reported case, urachal carcinoma can manifest as a mass in the region of the umbilicus.
Owing to its location and presentation, urachal carcinoma can clinically mimic a SMJ nodule.
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.
32,33) Pathologic stage is an important prognostic factor in urachal carcinoma.
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.
It is believed that urachal carcinomas arise from malignant transformation of columnar or glandular metaplastic epithelium.
Urachal Carcinomas of the Non glandular type: Salient Features and Considerations in Pathologic Diagnosis.