A Giant Mucinous Adenocarcinoma Arising within a Villous Adenoma of the Urachus : Case Report and Review of the Literature

Abstract EN

We present an exceptional case of a giant urachal tumor, consisting of both villous adenoma and mucinous adenocarcinoma of the urachus.

The tumor was incidentally discovered during investigations for renal failure.

Initial transurethral biopsies showed only a villous adenoma of the urachus.

Although the biopsies showed no malignancy, a radical cystoprostatectomy and broad excision of the urachus and umbilicus were performed.

At the same time, a bilateral nephroureterectomy was performed because of reflux-nephropathy and renal failure.

The indication for surgery was based on the typical imaging aspects, raising the suspicion of an underlying urachal adenocarcinoma (size and location).

Indeed, at final histopathology a concomitant well-differentiated adenocarcinoma of the urachus confined to the urachal mucosa was found.

The patient remained free of disease for 50 months of follow-up.

Only three previous cases of urachal adenocarcinoma associated with villous adenoma have been described.