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Difference between revisions of "Urachal carcinoma"
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'''Urachal carcinoma''' is an uncommon [[cancer|malignant tumour]] that arises from the urachus. Most urachal carcinomas are ''[[adenocarcinoma]]s''. | |||
==General== | |||
*Very rare<ref name=pmid16826585>{{Cite journal | last1 = Ashley | first1 = RA. | last2 = Inman | first2 = BA. | last3 = Sebo | first3 = TJ. | last4 = Leibovich | first4 = BC. | last5 = Blute | first5 = ML. | last6 = Kwon | first6 = ED. | last7 = Zincke | first7 = H. | title = Urachal carcinoma: clinicopathologic features and long-term outcomes of an aggressive malignancy. | journal = Cancer | volume = 107 | issue = 4 | pages = 712-20 | month = Aug | year = 2006 | doi = 10.1002/cncr.22060 | PMID = 16826585 }}</ref>~ 0.2% of bladder cancers.<ref name=pmid22901574>{{Cite journal | last1 = Bruins | first1 = HM. | last2 = Visser | first2 = O. | last3 = Ploeg | first3 = M. | last4 = Hulsbergen-van de Kaa | first4 = CA. | last5 = Kiemeney | first5 = LA. | last6 = Witjes | first6 = JA. | title = The clinical epidemiology of urachal carcinoma: results of a large, population based study. | journal = J Urol | volume = 188 | issue = 4 | pages = 1102-7 | month = Oct | year = 2012 | doi = 10.1016/j.juro.2012.06.020 | PMID = 22901574 }}</ref> | |||
*Younger <55 years-old. | |||
Treatment: | |||
*Partial cystectomy +/- umbilectomy. | |||
==Gross== | |||
*Lesion must be in urachus or dome of urinary bladder. | |||
==Microscopic== | |||
Features: | |||
*Usually adenocarcinoma. | |||
*Adjacent urothelium typically benign. | |||
DDx:<ref name=Ref_Amin2-143>{{Ref Amin|2-143}}</ref> | |||
*[[Adenocarcinoma of the urinary bladder]]. | |||
*Invasive [[urothelial carcinoma]] with glandular differentiation. | |||
*Metastatic adenocarcinoma/adenocarcinoma extending from another structure, e.g. [[colorectal adenocarcinoma]]. | |||
===Patterns=== | |||
*Enteric - looks like colonic adenocarcinoma. | |||
*Mucinous. | |||
*Signet ring. | |||
Note: | |||
*Urachal carcinoma may be ''nonglandular''.<ref name=pmid22301493>{{Cite journal | last1 = Paner | first1 = GP. | last2 = Barkan | first2 = GA. | last3 = Mehta | first3 = V. | last4 = Sirintrapun | first4 = SJ. | last5 = Tsuzuki | first5 = T. | last6 = Sebo | first6 = TJ. | last7 = Jimenez | first7 = RE. | title = Urachal carcinomas of the nonglandular type: salient features and considerations in pathologic diagnosis. | journal = Am J Surg Pathol | volume = 36 | issue = 3 | pages = 432-42 | month = Mar | year = 2012 | doi = 10.1097/PAS.0b013e31823fe49c | PMID = 22301493 }}</ref> | |||
===Images=== | |||
<gallery> | |||
Image:Urachal_carcinoma_-_very_low_mag.jpg | UC - very low mag. (WC) | |||
Image:Urachal_carcinoma_-_low_mag.jpg | UC - low mag. (WC) | |||
Image:Urachal_carcinoma_-_high_mag.jpg | UC - high mag. (WC) | |||
</gallery> | |||
==IHC== | |||
Features:<ref name=pmid19252435>{{Cite journal | last1 = Gopalan | first1 = A. | last2 = Sharp | first2 = DS. | last3 = Fine | first3 = SW. | last4 = Tickoo | first4 = SK. | last5 = Herr | first5 = HW. | last6 = Reuter | first6 = VE. | last7 = Olgac | first7 = S. | title = Urachal carcinoma: a clinicopathologic analysis of 24 cases with outcome correlation. | journal = Am J Surg Pathol | volume = 33 | issue = 5 | pages = 659-68 | month = May | year = 2009 | doi = 10.1097/PAS.0b013e31819aa4ae | PMID = 19252435 }}</ref> | |||
*CK20 +ve. | |||
*CK7 +ve/-ve. | |||
*CK34betaE12 +ve/-ve. | |||
*Beta-catenin -- usu cytoplasmic/membranous +ve. | |||
Others:<ref name=pmid21572312>{{Cite journal | last1 = Paner | first1 = GP. | last2 = McKenney | first2 = JK. | last3 = Barkan | first3 = GA. | last4 = Yao | first4 = JL. | last5 = Frankel | first5 = WL. | last6 = Sebo | first6 = TJ. | last7 = Shen | first7 = SS. | last8 = Jimenez | first8 = RE. | title = Immunohistochemical analysis in a morphologic spectrum of urachal epithelial neoplasms: diagnostic implications and pitfalls. | journal = Am J Surg Pathol | volume = 35 | issue = 6 | pages = 787-98 | month = Jun | year = 2011 | doi = 10.1097/PAS.0b013e3182189c11 | PMID = 21572312 }}</ref> | |||
*p63 -ve (+ve in only 3%). | |||
UC versus [[CRC]] -- not absolute but useful: | |||
*CK34betaE12 +ve in UC (-ve in CRC). | |||
*Beta-catenin -ve nuclei in UC (+ve nuclei in CRC). | |||
==Sign out== | |||
*The diagnosis is clinicopathologic; one needs imaging.<ref name=Ref_Amin2-143>{{Ref Amin|2-143}}</ref> | |||
==See also== | |||
[[Urinary bladder]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Urinary bladder]] | |||
[[Category:Diagnosis]] | |||