Introduction: Primary urachal cancer (UrCa) is rare, with an estimated incidence of 0.2% - 0.5% of all bladder tumors. Although the preferred treatment is surgical, there is no consensus on the best approach. We prese...Introduction: Primary urachal cancer (UrCa) is rare, with an estimated incidence of 0.2% - 0.5% of all bladder tumors. Although the preferred treatment is surgical, there is no consensus on the best approach. We present our experience managing 14 cases of primary UrCa. Methods: A retrospective analysis was conducted on the clinical records of a high-volume bladder cancer center in the UK to identify patients diagnosed with UrCa between May 2013 and June 2022. Results: 9 males and 6 females, aged between 30 and 85 years, were included. The diagnosis was most commonly made via flexible cystoscopy and CT for haematuria. 3 patients had metastasis at presentation, and while radiologically no patients showed positive lymph nodes, 2 patients were found to have positive lymph nodes on histopathology. 13 patients underwent partial cystectomy, with 1 undergoing radical cystoprostatectomy. 8 patients underwent concurrent umbilectomy and/or lymphadenectomy. The most common histological subtype was mucinous adenocarcinoma. 2 patients experienced local recurrence and underwent transurethral resection, while 6 patients experienced metastasis. Metastasis-free survival rate was 74.1% and 55.6% at 12 and 24 months, respectively. Umbilectomy and lymphadenectomy did not decrease rates of positive surgical margin, local recurrence, metastasis, or mortality. Conclusions: UrCa is a rare and aggressive malignancy that can occur at any age and may be advanced upon presentation. Bladder-sparing surgery is becoming more prevalent, with chemotherapy being reserved for recurrence or metastasis. In our series, routine umbilectomy and lymphadenectomy did not improve oncologic outcomes. However, lymphadenectomy may have a role in cancer staging.展开更多
Objectives:We sought to evaluate modern diagnostic and treatment options for urachal adenocarcinoma(UAC)and to provide clarity regarding the available options and their outcomes for this poorly understood yet damaging...Objectives:We sought to evaluate modern diagnostic and treatment options for urachal adenocarcinoma(UAC)and to provide clarity regarding the available options and their outcomes for this poorly understood yet damaging disease.Material and methods:We conducted a systematic literature search in PubMed and Medline focusing on updated management of UAC.Results:Surgical intervention continues to be the mainstay of treatment for localized UAC.However,with the increased availability of molecular and genetic profiling,chemotherapy has consistently demonstrated promising response rates and survival outcomes,especially for a disease that commonly presents in a metastatic stage.The role of checkpoint inhibitors remains under investigation.Cross-sectional imaging is vital during postoperative surveillance.However,there may also be a role for the adoption of cystoscopy to detect bladder recurrence.Conclusions:Although the importance of surgical resection remains unchanged,improved survival outcomes with chemotherapy have been found in small retrospective studies.Randomized trial data are required to further assess the influence of systemic treatment as a primary or adjuvant therapy.Moreover,a stringent follow-up regimen incorporating evaluation for distant and local recurrence of UAC must be evaluated and adopted.展开更多
The purpose of these serial cases was to report the diagnostic and therapeutic features of urachal fistulas at Yalgado Ouedraogo teaching Hospital. We have reported retrospectively two cases of urachus fistula at the ...The purpose of these serial cases was to report the diagnostic and therapeutic features of urachal fistulas at Yalgado Ouedraogo teaching Hospital. We have reported retrospectively two cases of urachus fistula at the Surgery Department of Yalgado Ouedraogo Teaching Hospital in Ouagadougou. The parameters studied were sex, age, reason for consultation, clinical and paraclinical signs, treatment, length of hospital stay, delay of urinary catheterisation and evolution. Two serial cases of urachal fistula were reported, one 14 years old female patient and a 32 years old male patient. Clinical signs were marked by urine flow through the umbilicus. The diagnosis was made by fistulography in one case and during surgery for the second case. The treatment was surgical and consisted of laparotomy followed by removal of the urachal fistula from bladder. The urinary catheter was removed after 10 days. The postoperative course for the two patients was uneventful.展开更多
Objective: To study the clinical characteristics, diag nosis and treatment of primary urachal adenocarcinoma. Methods: Six cases of histologically confirmed primary urachal adenocarcinoma were retrospectively reviewe...Objective: To study the clinical characteristics, diag nosis and treatment of primary urachal adenocarcinoma. Methods: Six cases of histologically confirmed primary urachal adenocarcinoma were retrospectively reviewed. Results: The median age of this series was 55. Incidence duration was 4 to 7 months. Tumors were found in all patients by cystoscopy, CT and B ultrasound. Urachal adenocarcinoma in 4 cases and bladder cancer in 2 cases were diagnosed before operation. The segmental resection of tissues around the mass was performed in 5 cases, all patients received chemotherapy or radiotherapy. Con clusion: It was difficult to confirmed diagnosis early, and differential diagnosis from bladder cancer was important. The wide surgical excision should be taken with adjuvant chemo or radiotherapy.展开更多
<strong>Introduction:</strong> The urachus or median umbilical ligament is a fibrous cord originating from the allantoic canal’s involution. It extends from the bladder dome to the posterior umbilicus. A ...<strong>Introduction:</strong> The urachus or median umbilical ligament is a fibrous cord originating from the allantoic canal’s involution. It extends from the bladder dome to the posterior umbilicus. A partial or a total defect of the urachus channel’s obliteration after the fifth month of gestation can be the origin of urachal abnormalities. A complication of symptomatic urachal anomalies occurs when the cyst fistulizes to adjacent viscera. We report the first case of a diverticulosis-related sigmoid-urachal-scrotal cyst in a 55-year-old patient.<strong> Case Report:</strong> A 55-year-old male visited the clinic with intermittent fever, lower abdominal pain, swelling in the groin and scrotal area. Abdominal examination revealed a diffuse tender in the lower abdomen and suprapubic area. Non-contrast abdominal CT imaging showed a cystic lesion with an air-fluid level and possibly debris positioned superiorly to the bladder at the abdominal wall. The sigmoid colon seemed attached to this cystic lesion. Air observed in the scrotum and subcutaneous. The damaged part of the sigmoid colon was repaired. Then the abscess was drained. Urachus was wholly resected and removed. After five days of follow-up, the patient was discharged without any problem. A severely inflamed urachus was found in pathology. <strong>Conclusion: </strong>Although it is rare and its symptoms are non-specific, the urachal abscess should be suspected if there is persistent fever and suprapubic pain, especially in patients with diverticula. It is recommended to remove it when the diagnosis is made, considering the complications that may occur.展开更多
文摘Introduction: Primary urachal cancer (UrCa) is rare, with an estimated incidence of 0.2% - 0.5% of all bladder tumors. Although the preferred treatment is surgical, there is no consensus on the best approach. We present our experience managing 14 cases of primary UrCa. Methods: A retrospective analysis was conducted on the clinical records of a high-volume bladder cancer center in the UK to identify patients diagnosed with UrCa between May 2013 and June 2022. Results: 9 males and 6 females, aged between 30 and 85 years, were included. The diagnosis was most commonly made via flexible cystoscopy and CT for haematuria. 3 patients had metastasis at presentation, and while radiologically no patients showed positive lymph nodes, 2 patients were found to have positive lymph nodes on histopathology. 13 patients underwent partial cystectomy, with 1 undergoing radical cystoprostatectomy. 8 patients underwent concurrent umbilectomy and/or lymphadenectomy. The most common histological subtype was mucinous adenocarcinoma. 2 patients experienced local recurrence and underwent transurethral resection, while 6 patients experienced metastasis. Metastasis-free survival rate was 74.1% and 55.6% at 12 and 24 months, respectively. Umbilectomy and lymphadenectomy did not decrease rates of positive surgical margin, local recurrence, metastasis, or mortality. Conclusions: UrCa is a rare and aggressive malignancy that can occur at any age and may be advanced upon presentation. Bladder-sparing surgery is becoming more prevalent, with chemotherapy being reserved for recurrence or metastasis. In our series, routine umbilectomy and lymphadenectomy did not improve oncologic outcomes. However, lymphadenectomy may have a role in cancer staging.
文摘Objectives:We sought to evaluate modern diagnostic and treatment options for urachal adenocarcinoma(UAC)and to provide clarity regarding the available options and their outcomes for this poorly understood yet damaging disease.Material and methods:We conducted a systematic literature search in PubMed and Medline focusing on updated management of UAC.Results:Surgical intervention continues to be the mainstay of treatment for localized UAC.However,with the increased availability of molecular and genetic profiling,chemotherapy has consistently demonstrated promising response rates and survival outcomes,especially for a disease that commonly presents in a metastatic stage.The role of checkpoint inhibitors remains under investigation.Cross-sectional imaging is vital during postoperative surveillance.However,there may also be a role for the adoption of cystoscopy to detect bladder recurrence.Conclusions:Although the importance of surgical resection remains unchanged,improved survival outcomes with chemotherapy have been found in small retrospective studies.Randomized trial data are required to further assess the influence of systemic treatment as a primary or adjuvant therapy.Moreover,a stringent follow-up regimen incorporating evaluation for distant and local recurrence of UAC must be evaluated and adopted.
文摘The purpose of these serial cases was to report the diagnostic and therapeutic features of urachal fistulas at Yalgado Ouedraogo teaching Hospital. We have reported retrospectively two cases of urachus fistula at the Surgery Department of Yalgado Ouedraogo Teaching Hospital in Ouagadougou. The parameters studied were sex, age, reason for consultation, clinical and paraclinical signs, treatment, length of hospital stay, delay of urinary catheterisation and evolution. Two serial cases of urachal fistula were reported, one 14 years old female patient and a 32 years old male patient. Clinical signs were marked by urine flow through the umbilicus. The diagnosis was made by fistulography in one case and during surgery for the second case. The treatment was surgical and consisted of laparotomy followed by removal of the urachal fistula from bladder. The urinary catheter was removed after 10 days. The postoperative course for the two patients was uneventful.
文摘Objective: To study the clinical characteristics, diag nosis and treatment of primary urachal adenocarcinoma. Methods: Six cases of histologically confirmed primary urachal adenocarcinoma were retrospectively reviewed. Results: The median age of this series was 55. Incidence duration was 4 to 7 months. Tumors were found in all patients by cystoscopy, CT and B ultrasound. Urachal adenocarcinoma in 4 cases and bladder cancer in 2 cases were diagnosed before operation. The segmental resection of tissues around the mass was performed in 5 cases, all patients received chemotherapy or radiotherapy. Con clusion: It was difficult to confirmed diagnosis early, and differential diagnosis from bladder cancer was important. The wide surgical excision should be taken with adjuvant chemo or radiotherapy.
文摘<strong>Introduction:</strong> The urachus or median umbilical ligament is a fibrous cord originating from the allantoic canal’s involution. It extends from the bladder dome to the posterior umbilicus. A partial or a total defect of the urachus channel’s obliteration after the fifth month of gestation can be the origin of urachal abnormalities. A complication of symptomatic urachal anomalies occurs when the cyst fistulizes to adjacent viscera. We report the first case of a diverticulosis-related sigmoid-urachal-scrotal cyst in a 55-year-old patient.<strong> Case Report:</strong> A 55-year-old male visited the clinic with intermittent fever, lower abdominal pain, swelling in the groin and scrotal area. Abdominal examination revealed a diffuse tender in the lower abdomen and suprapubic area. Non-contrast abdominal CT imaging showed a cystic lesion with an air-fluid level and possibly debris positioned superiorly to the bladder at the abdominal wall. The sigmoid colon seemed attached to this cystic lesion. Air observed in the scrotum and subcutaneous. The damaged part of the sigmoid colon was repaired. Then the abscess was drained. Urachus was wholly resected and removed. After five days of follow-up, the patient was discharged without any problem. A severely inflamed urachus was found in pathology. <strong>Conclusion: </strong>Although it is rare and its symptoms are non-specific, the urachal abscess should be suspected if there is persistent fever and suprapubic pain, especially in patients with diverticula. It is recommended to remove it when the diagnosis is made, considering the complications that may occur.
