Abstract
The urachus establishes a connection between the dome of the bladder and the umbilicus throughout fetal life. If the urachus does not close completely, malignancy is a potential complication. The primary treatment for malignant urachal tumor is surgical excision. A 61-year-old male patient diagnosed with urachal carcinoma had undergone partial cystectomy 25 years previously. Twenty years later, local recurrence was treated with another partial cystectomy without umbilical remnant excision. Recurrence at the umbilical site was excised 2 years later, but intraperitoneal invasion had occurred, and the patient underwent a total colectomy at that time. Local disease and disseminated metastases in the thorax and intra- and extraperitoneal areas were noted upon admission to our hospital. Urachal carcinomas are usually aggressive tumors, and surgical treatment should include partial or radical cystectomy and excision of the urachus and umbilicus, to prevent local recurrence and distant metastasis.
Highlights
The urachus is the vestigial remnant of the cloaca and the allantois, forming a fibrous embryonic remnant that extends from the dome of the bladder to the umbilicus
We reported an unusual case of a patient with an inadequately treated urachal carcinoma who did not receive chemotherapy or radiotherapy, over a period of 25 years
Ninety percent of urachal carcinomas occur at the bladder side of the urachus, originating from the level of the dome, and the malignancy progresses through to the urachal side
Summary
The urachus is the vestigial remnant of the cloaca and the allantois, forming a fibrous embryonic remnant that extends from the dome of the bladder to the umbilicus. Urachal remnants may be noted in infants and during childhood, where they are most frequently found as thin-walled, internally homogenous cysts, containing straw yellow umbilical fluid. The development of malignancy is noted in adults. Urachal carcinomas constitute about 0.2% of all bladder tumors [1]. The primary treatment for malignant urachal pathologies is surgical excision. We reported an unusual case of a patient with an inadequately treated urachal carcinoma who did not receive chemotherapy or radiotherapy, over a period of 25 years
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have