Urachal cancer

Urachal Cancer

Urachal cancer is a rare type of cancer that originates in the urachus, a vestigial remnant of the allantois that connects the fetal bladder to the umbilicus. This type of cancer is most commonly found in the bladder dome and is often diagnosed at an advanced stage due to its asymptomatic nature in early development.

Pathophysiology

The urachus is a fibrous cord that is usually obliterated after birth, forming the median umbilical ligament. However, in some cases, remnants of the urachus persist and can give rise to malignancies. Urachal cancer is predominantly adenocarcinoma, accounting for about 90% of cases, with other histological types being much less common.

Symptoms

Symptoms of urachal cancer are often non-specific and may include hematuria (blood in urine), abdominal pain, and a palpable mass. Due to the deep location of the urachus, these symptoms often appear only when the disease is advanced.

Diagnosis

Diagnosis of urachal cancer typically involves imaging studies such as ultrasound, CT scan, or MRI to identify the presence of a mass. Cystoscopy may also be performed to visualize the bladder and obtain tissue samples for biopsy.

Treatment

The primary treatment for urachal cancer is surgical resection, often involving a partial or radical cystectomy with en bloc resection of the urachus and umbilicus. Chemotherapy and radiation therapy may be considered in cases where the cancer is not completely resectable or has metastasized.

Prognosis

The prognosis for urachal cancer depends on the stage at diagnosis and the completeness of surgical resection. Early-stage cancers that are completely resected have a better prognosis, while advanced-stage cancers have a poorer outcome.

Related Pages

• Bladder cancer
• Adenocarcinoma
• Cystectomy

References

• Herr, H. W., & Bochner, B. H. (2007). "Urachal carcinoma: the case for extended partial cystectomy." The Journal of Urology, 178(4), 1122-1124.
• Ashley, R. A., Inman, B. A., Routh, J. C., & Rohlinger, A. L. (2006). "Urachal carcinoma: clinicopathologic features and long-term outcomes of an aggressive malignancy." Cancer, 107(4), 712-720.

Images

Urachal carcinoma under high magnification.

CDX2 staining in urachal carcinoma.

• Urachal cancer
  Urachal cancer
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  Urachal carcinoma - high magnification
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  Urachal carcinoma CDX2 staining at 200x
• Wolffian duct remnant
  Wolffian duct remnant