A case of metastatic urachal adenocarcinoma treated with several different chemotherapeutic regimens.

Urachal cancer is a rare form of bladder cancer that arises from the urachus, a vestigial musculofibrous band that extends from the dome of the bladder to the umbilicus. Urachal cancer often presents at an advanced stage and has a dismal prognosis. We present a case of a young woman with urachal cancer that recurred rapidly post-partial cystectomy. The patient was treated with up to 6 different chemotherapy regimens, including an oral antiangiogenic drug as part of a clinical trial. Our case illustrates the aggressive nature of this disease, the difficulty in accessing drugs for the treatment of rare cancers and the lack of late stage clinical trials to help guide therapeutic decisions.