Abstract
We report the case of a urachal adenocarcinoma diagnosed in a 55-year-old patient - presenting with dysuria and bloody urine. After admission to hospital, urethrocystoscopy showed large bleeding mass in prostatic part of urethra. He underwent transurethral resection of prostate and cystectomy, with implantations of JJ stents. Immunohistochemistry revealed urachal adenocarcinoma, a rare type of urogenital carcinoma, presented only in 5% of all cancer types. The patient was treated with dual modality, chemotherapy and radiotherapy.
Highlights
Urachal adenocarcinomas are rare tumors that likely arise from metaplasia of mucosal surface of prostatic part of urethra or from periurethral glands [1, 2]
Anatomic location largely determines the hystological type of cancer
No missteps were taken, there was a clinical mislead to prostate cancer because of symptom presenta-. Combining both modalities is expected to lead to a better outcome in treating urachal adenocarcinomas
Summary
Urachal adenocarcinomas are rare tumors that likely arise from metaplasia of mucosal surface of prostatic part of urethra or from periurethral glands [1, 2]. Causes include chronic inflammation and venereal infections, most likely human papillomavirus The rareness of these carcinomas represents a formidable diagnostic challenge because of a poor therapeutic benefit in advanced stages even with aggressive treatment. Scheduled reevaluation after two and half months was done and PET CT scan revealed mass of 47 mm infiltrating prostatic part of urethra in width of 28 mm, with diverticulous lesions on the right wall of the urinary bladder of 8 mm, significant retroperitoneal lymphadenomegaly and cystic lesion in 5th liver segment, with rectal abdominal muscle infiltration. Two years after the initial symptoms occurred, patient is in a great amount of pain, on daily opioid patches, has bilateral nephrostomies and on close follow-up protocol because there are no further treatment recommendations
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