A rare case of primary urachal mucinous adenocarcinoma

Abstract

Background: Urachal cancers arising from the urachus or its remnants, is a very rare and aggressive type of cancer in which occurrence is only about 0.01% of all adult cancers. Till date, there is no standard chemotherapy regimes or randomized trials due to the rarity of the disease. In 2007, not more than 350 written case reports in English has been published worldwide. This case report aims to share our department’s modest experience in management of a primary urachal mucinous adenocarcinoma in the adjuvant setting. Case Description: We report a 54-year-old gentleman from Kudat, Sabah, who presented with an umbilical mass and lower abdominaldiscomfort. Investigations revealed a primary urachal mucinous adenocarcinoma in May 2016 and he had undergone en-bloc resection of urachal tumour up to the serosal layer of the dome of bladder. Post-operatively, he received 12 cycles of adjuvant chemotherapy in the form of FOLFOX-4 regime from June 2016 to December 2016. He was last reviewed in September 2017 and is currently well and asymptomatic. Latest CT scan did not show any tumour recurrence nor distant metastasis. Results: This gentleman has been disease free for 16 months with no clinical or radiological evidence of local recurrence or distant metastasis. Conclusion: There are only few picaresque responses treating urachal cancers with chemotherapy regimens used for bladder carcinomas. Taking into consideration the enteric type histology of urachal adenocarcinomas, thechemotherapy regimes used for gastrointestinal malignancies may possibly yield better response and outcome.