Joniau Steven, Lerut Evelyne, Van Poppel Hein
Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
Case Rep Med. 2009;2009:818646. doi: 10.1155/2009/818646. Epub 2010 Feb 16.
We present an exceptional case of a giant urachal tumor, consisting of both villous adenoma and mucinous adenocarcinoma of the urachus. The tumor was incidentally discovered during investigations for renal failure. Initial transurethral biopsies showed only a villous adenoma of the urachus. Although the biopsies showed no malignancy, a radical cystoprostatectomy and broad excision of the urachus and umbilicus were performed. At the same time, a bilateral nephroureterectomy was performed because of reflux-nephropathy and renal failure. The indication for surgery was based on the typical imaging aspects, raising the suspicion of an underlying urachal adenocarcinoma (size and location). Indeed, at final histopathology a concomitant well-differentiated adenocarcinoma of the urachus confined to the urachal mucosa was found. The patient remained free of disease for 50 months of follow-up. Only three previous cases of urachal adenocarcinoma associated with villous adenoma have been described.
我们报告了一例罕见的巨大脐尿管肿瘤病例，该肿瘤由脐尿管绒毛状腺瘤和黏液腺癌组成。该肿瘤是在因肾衰竭进行检查时偶然发现的。最初的经尿道活检仅显示脐尿管绒毛状腺瘤。尽管活检未显示恶性，但仍进行了根治性膀胱前列腺切除术以及脐尿管和脐的广泛切除。同时，由于反流性肾病和肾衰竭，进行了双侧肾输尿管切除术。手术指征基于典型的影像学表现，这引发了对潜在脐尿管腺癌（大小和位置）的怀疑。实际上，最终组织病理学检查发现了同时存在的局限于脐尿管黏膜的高分化脐尿管腺癌。患者在50个月的随访中无疾病复发。此前仅报道过三例与绒毛状腺瘤相关的脐尿管腺癌病例。
