Tilahun Seyfe Bekele, Tolessa Sewunet Muluneh, Shiferaw Samuel Fekadu, Wake Azeb Gezahegn
Addis Ababa University, College of Health Sciences, Department of Surgery, Addis Ababa, Ethiopia.
Addis Ababa University, College of Health Sciences, Department of Surgery, Addis Ababa, Ethiopia.
Int J Surg Case Rep. 2024 Jul;120:109791. doi: 10.1016/j.ijscr.2024.109791. Epub 2024 May 25.
Primary urachal adenocarcinoma (PUA) is a rare form of cancer that arises from the urachus, a vestigial remnant of the allantois and cloaca during embryonic development. The exact pathogenesis of PUA is not well understood, but it is believed to arise from glandular epithelium remnants within the urachus. The rarity of this type of cancer makes it difficult to comprehensively study its epidemiology.
This case report describes a 47-year-old male patient who presented with intermittent painless hematuria and fatigue for two months. Cystoscopy showed a single growth at the dome of the urinary bladder, and abdominopelvic CT scan with contrast revealed a 3*2 cm enhancing growth at the dome of the bladder suspicious of urachal origin tumor. The patient was diagnosed with urachal adenocarcinoma (PT2) after pathological examination. The patient underwent partial cystectomy and umbilicectomy.
Patients with PUA often present with nonspecific symptoms that can delay the diagnosis. The most common symptom is hematuria, which is present in approximately two-thirds of the patients. The diagnosis of PUA is challenging and relies on a combination of clinical presentation, imaging, and histopathological examination.
The mainstay of treatment for PUA is surgical resection, which may include partial cystectomy or radical cystectomy with en bloc resection of the urachus and umbilicus. It is esential to report all cases of primary urachal adenocrcinoma.
原发性脐尿管腺癌（PUA）是一种罕见的癌症，起源于脐尿管，脐尿管是胚胎发育过程中尿囊和泄殖腔的遗迹。PUA的确切发病机制尚不完全清楚，但据信它起源于脐尿管内的腺上皮残余。这种癌症的罕见性使得全面研究其流行病学变得困难。
本病例报告描述了一名47岁男性患者，他出现间歇性无痛血尿和疲劳症状两个月。膀胱镜检查显示膀胱顶部有单个肿物，腹部盆腔增强CT扫描显示膀胱顶部有一个3×2厘米的强化肿物，怀疑起源于脐尿管肿瘤。经病理检查，该患者被诊断为脐尿管腺癌（PT2）。患者接受了部分膀胱切除术和脐切除术。
PUA患者常表现出非特异性症状，这可能会延迟诊断。最常见的症状是血尿，约三分之二的患者会出现。PUA的诊断具有挑战性，依赖于临床表现、影像学检查和组织病理学检查的综合判断。
PUA的主要治疗方法是手术切除，可能包括部分膀胱切除术或根治性膀胱切除术，同时整块切除脐尿管和脐部。报告所有原发性脐尿管腺癌病例至关重要。
