Chejara Rajkumar, Goyal Sunny, Choudhary Sushila, Shah Sameeksha
Department of Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Indian J Surg Oncol. 2023 Sep;14(3):677-681. doi: 10.1007/s13193-023-01736-6. Epub 2023 Mar 27.
Urachal adenocarcinoma is one of the rare and aggressive neoplasms that often presents at an advanced stage and has a poor prognosis. Urachal adenocarcinoma makes up 0.17 to 0.34% of all bladder carcinomas. Patients commonly present with hematuria. Wide local excision of urachal mass with umbilicus and surrounding soft tissue en bloc combined with partial or radical cystectomy and bilateral pelvic lymphadenectomy is considered to be the primary surgical management. However, many publications in literature report that en bloc removal of tumor with umbilicus, entire urachal ligament, and bladder dome alone has long-term survival and disease-free period. Here, we present a case of a 50-year-old post-menopausal female patient with a fungating mass in the umbilical region of size approximately 10 cm in maximum diameter with mucopurulent discharge from the mass. The patient had no history of any hematuria, mucinuria, burning micturition, or any particles in urine. A laparotomy was performed, and tumor mass along with the cuff of the bladder dome was removed as en bloc along with umbilectomy. This case report highlights a rare case of urachal adenocarcinoma with a fungating mass of large size in a female patient which is otherwise more commonly seen in males. A review of published literature is also presented.
脐尿管腺癌是一种罕见的侵袭性肿瘤，常于晚期出现，预后较差。脐尿管腺癌占所有膀胱癌的0.17%至0.34%。患者通常表现为血尿。将脐尿管肿物与脐部及周围软组织整块广泛局部切除，联合部分或根治性膀胱切除术及双侧盆腔淋巴结清扫术被认为是主要的手术治疗方法。然而，许多文献报道仅将肿瘤与脐部、整个脐尿管韧带及膀胱顶部整块切除就可实现长期生存和无病期。在此，我们报告一例50岁绝经后女性患者，其脐部有一蕈状肿物，最大直径约10 cm，肿物有黏液脓性分泌物。该患者无血尿、黏液尿、排尿烧灼感或尿中出现任何颗粒的病史。进行了剖腹手术，将肿瘤连同膀胱顶部的袖口状组织与脐部一并整块切除。本病例报告突出了一例罕见的女性脐尿管腺癌，其具有较大的蕈状肿物，而该病在男性中更为常见。同时还对已发表的文献进行了综述。
