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Difference between revisions of "Urachal carcinoma"
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<pre> | |||
Mass, Urachus, Resection: | |||
- ADENOCARCINOMA, consistent with urachal primary, see comment. | |||
-- Margins clear. | |||
Comment: | |||
The sections show malignant cells within the perivesicular soft tissue arranged in nests and glands with necrosis. The lesion center is within the bladder wall, rather than at the mucosa. The sampled bladder mucosa is within normal limits. | |||
The tumour stains as follows: | |||
POSITIVE: CDX2 (focal, moderate nuclear), CK20 (focal, moderate membranous). | |||
NEGATIVE: CK7, p63, CK5/6, GATA3, beta-catenin (membranous only, nuclei negative). | |||
The histomorphology, immunoprofile and imaging are compatible with a primary urachal adenocarcinoma. | |||
The morphology and immunoprofile of urachal adenocarcinoma overlaps with primary adenocarcinoma of the bladder and somewhat with colorectal adenocarcinoma. Primary adenocarcinoma of the bladder is unlikely as the sampled urothelium is benign, the lesion is centered within the wall and no history of bladder tumours was found. Metastatic colorectal cancer seems unlikely from the clinical information available. | |||
The CAP bladder synoptic is not applicable to urachal carcinoma. | |||
In the context of the "Sheldon Staging System" for urachal carcinoma, this case would be pT3a. | |||
</pre> | |||
Note: | |||
*The diagnosis is a clinicopathologic diagnosis - one needs imaging to make it.<ref name=Ref_Amin2-143>{{Ref Amin|2-143}}</ref> | *The diagnosis is a clinicopathologic diagnosis - one needs imaging to make it.<ref name=Ref_Amin2-143>{{Ref Amin|2-143}}</ref> | ||
*May be [[cancer staging|staged]] with the ''Sheldon system''.<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> | *May be [[cancer staging|staged]] with the ''Sheldon system''.<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> | ||