Jandou Issam, Ettanji Adnan, Mohammed Ettaouil, Moataz Amine, Mohammed Dakir, Debbagh Adil, Aboutaieb Rachid
University Hospital Center Ibn Rochd Casablanca, Morocco.
Faculté de Médicine et de Pharmacie Casablanca, Morocco.
Ann Med Surg (Lond). 2021 Apr 21;65:102335. doi: 10.1016/j.amsu.2021.102335. eCollection 2021 May.
Urachus adenocarcinoma is an extremely rare malignant tumor characterized by its insidious evolution responsible for the delay in diagnosis. Several scientific works have tried to study the indication of adjuvant treatment, therefore the prognosis is still poor.
We report the case of a 50-year-old patient with no pathological history who consulted for an episode of intermittent urinary mucosal secretion aggravated by the appearance of macroscopic hematuria. Without other associated clinical signs. Imaging examinations revealed a mass at the expense of the upper wall of the bladder. The cystoscopy allowed us to visualize the mass and the biopsy. Histological study revealed an adenocarcinoma of urachus. The patient underwent surgical exeresis and adjuvant chemotherapy. The evolution was marked by a deterioration of the general condition despite adequate management.
Due to its topography, urachus cancer usually manifests as a bladder tumor, exceptionally as much as an anterior umbilical or extraperitoneal tumor. Few studies have been done on this neoplasm; however surgery still has a primary place in therapeutic management.
The scarcity of cases of urachus cancer makes the publications scarce and the lack of multicenter clinical and randomized trials explains the disagreement about adjuvant treatments.
脐尿管腺癌是一种极其罕见的恶性肿瘤，其特点是发展隐匿，导致诊断延迟。一些科学研究试图探讨辅助治疗的指征，但其预后仍然很差。
我们报告一例50岁无病史患者，因间歇性尿道黏膜分泌物增多并出现肉眼血尿前来就诊，无其他相关临床症状。影像学检查显示膀胱上壁有一肿块。膀胱镜检查使我们能够看到肿块并进行活检。组织学研究显示为脐尿管腺癌。患者接受了手术切除及辅助化疗。尽管治疗得当，但患者的总体状况仍逐渐恶化。
由于其解剖位置，脐尿管癌通常表现为膀胱肿瘤，极少数情况下表现为脐前或腹膜外肿瘤。关于这种肿瘤的研究很少；然而，手术在治疗管理中仍占据首要地位。
脐尿管癌病例稀少，使得相关出版物也很匮乏，且缺乏多中心临床和随机试验，这解释了在辅助治疗方面存在的分歧。
