Abstract YO14
Case summary
Urachal cancer is a rare neoplasm which represents approximately 0.5-2% of all bladder cancer.
A 52 year old Filipino male presented with painless hematuria. Physical examination was unremarkable. KUB ultrasound showed a bladder mass so Cystoscopy–TUR was done. Histopathology revealed adenocarcinoma with involvement of muscularis propria. He was advised surgery but did not consent. Contrast-enhanced abdominal computed tomography (CT) showed a well-defined, slightly wall enhancing, midline infraumbilical complex soft tissue mass measuring 3.6x4.0x5.1cm in the anterosuperior aspect of the urinary bladder extending to the urachus with no communication to the umbilicus. Cystoscopy, Partial Cystectomy with Umbilectomy was done. Intra-operative findings: bladder mass at the dome approximately 2-3cm in size, necrotic tissue with band of tissue directly connected to the umbilicus. Histopathology was urachal adenocarcinoma which extends to the urinary bladder muscularis propria and perivesical tissue. He was advised close follow-up.
After one year, he started to experience difficulty initiating urine. Repeat CT scan showed: urinary bladder with an intraluminal enhancing nodule in the superoanterior wall measuring 1.5x1.7cm, irregular anterior urinary bladder wall thickening measuring 7.3x1.5cm is also noted, small anterior perivesical nodes are noted measuring 0.7x1.2 cm. Cysto-TURP of Bladder Tumor, Exploratory Laparotomy, Adhesiolysis, was done. Intra-operative findings were: smooth urethral mucosa without stenosis or stricture; pedunculated broad-based, friable, pink fleshy mass seen at the posterolateral bladder wall, measuring 5-8 cm in greatest diameter; flat erythematous lesion measuring 2cm noted at bladder dome; muiltiple nodularities along peritoneum with some attached to ileal loops. Specimen’s pathology reported adenocarcinoma and peritoneal nodularities were metastatic adenocarcinoma; morphological features favored the diagnosis of urachal adenocarcinoma. CT scan of the Chest showed innumerable varisized non-calcified parenchymal, fissural, and subpleural nodules scattered in both lungs which were worrisome for metastasis. The patient has received systemic chemotherapy with Cisplatin and Fluorouracil.
Clinical trial identification
Editorial acknowledgement
Resources from the same session
220P - An outcome analysis of robotassisted radical nephroureterectomy with extended template lymphadenectomy for upper tract urothelial carcinoma
Presenter: Ashwin Tamhankar
Session: Poster display session
Resources:
Abstract
221P - Comparative analysis of first-line immune checkpoint inhibitor versus carboplatin-based chemotherapy for cisplatin-ineligible metastatic urothelial carcinoma: A multicenter, retrospective real-world evidence
Presenter: Hsiang‐Lan Lai
Session: Poster display session
Resources:
Abstract
222P - Does tumor grade really improve the prognostic ability of the staging system for men with penile cancer: A SEER database analysis
Presenter: Ravi Kanodia
Session: Poster display session
Resources:
Abstract
223TiP - EV-301: A phase III trial in progress evaluating enfortumab vedotin versus chemotherapy in patients with locally advanced or metastatic urothelial carcinoma
Presenter: Daniel Petrylak
Session: Poster display session
Resources:
Abstract
230P - Olaparib maintenance therapy in patients (pts) with a BRCA1 and/or BRCA2 mutation (BRCAm) and newly diagnosed advanced ovarian cancer (OC): SOLO1 China cohort
Presenter: Lingying Wu
Session: Poster display session
Resources:
Abstract
231P - Cost-effectiveness of olaparib vs routine surveillance in the maintenance setting for patients with BRCA-mutated advanced ovarian cancer after response to first-line platinum-based chemotherapy in Singapore
Presenter: David SP Tan
Session: Poster display session
Resources:
Abstract
233P - Incorporation of correlative studies in ovarian cancers in the era of precision medicine: Assessment of accountability and utility
Presenter: Nadia Hitchen
Session: Poster display session
Resources:
Abstract
234P - Implementation of mainstream BRCA testing in epithelial ovarian cancer in a tertiary centre
Presenter: Edbert Wong
Session: Poster display session
Resources:
Abstract
235P - The efficacy of radiation therapy in ovarian carcinoma: A propensity score analysis of a population-based study
Presenter: Jian-Guo Zhou
Session: Poster display session
Resources:
Abstract
236P - Front-line maintenance therapy for platinum-sensitive ovarian cancer: What’s next PARP inhibitors?
Presenter: Han Gong
Session: Poster display session
Resources:
Abstract