Adenocarcinoma and Urachal Lithiasis, Review of the Literature and Report of a Case

Abstract

Aims: Present a clinical case of a patient with urachal adenocarcinoma and urachal lithiasis, who underwent diagnostic cystoscopy and partial cystectomy as well as a review of the literature. Background: Urachal adenocarcinoma is a tumor with a rare incidence, which is diagnosed late, therefore it can have a poor prognosis, and in many cases local recurrences and metastases occur within 2 years after diagnosis. Clinical case: A 61-year-old female patient with symptoms of hematuria of 10 days of evolution, associated with pain in the suprapubic region of mild/moderate intensity. She refers that she has had recurrent urinary tract infections, for which it was decided to perform a urotomography, evidencing persistence of the urachus in the tertiary care hospital (Roosevelt Hospital). Diagnostic cystoscopy was performed confirming the presence of urachus and intravesical stones. A partial cystectomy was subsequently performed, and the biopsy reported moderately differentiated urachal adenocarcinoma. The patient is discharged, leaving control appointments for external consultation. Conclusions: Partial cystectomy and resection of the urachal remnant is the ideal treatment. This type of surgery has benefits by decreasing morbidity, preserving the perivesical nerves, and preserving the normal function of the urinary tract. Generally, partial cystectomy is indicated in patients who present a solitary tumor in the bladder dome and lesions on the lateral side of the bladder that do not affect the ureteral tract. It is important to have constant monitoring of patients through diagnostic cystoscopies due to the risk that there may be recurrences or metastases.