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Difference between revisions of "Urachal carcinoma"
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*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> | *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> | ||
*Often younger <55 years-old. | *Often younger <55 years-old. | ||
*Poor prognosis<ref name=pmid24136277/> - especially for high Sheldon stage.<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> | *Poor prognosis<ref name=pmid24136277/> - especially for high [[Sheldon stage]].<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> | ||
Clinical: | Clinical: | ||
*Hematuria - classic | *Hematuria - classic presentation.<ref name=pmid24136277>{{Cite journal | last1 = Shao | first1 = GJ. | last2 = Cai | first2 = L. | last3 = Li | first3 = XS. | last4 = Song | first4 = G. | last5 = Li | first5 = XY. | last6 = He | first6 = ZS. | last7 = Zhou | first7 = LQ. | title = [Urachal carcinoma: experience of a clinical center within 30 years]. | journal = Beijing Da Xue Xue Bao | volume = 45 | issue = 5 | pages = 774-8 | month = Oct | year = 2013 | doi = | PMID = 24136277 }}</ref> | ||
Treatment: | Treatment: | ||
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*Usually gland forming, i.e. adenocarcinoma. | *Usually gland forming, i.e. adenocarcinoma. | ||
*+/-Mucinous component. | *+/-Mucinous component. | ||
Features making it | Features making it ''urachal carcinoma'' (modified Sheldon criteria) - all required:<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> | ||
#Located in bladder dome or anterior wall. † | #Located in bladder dome or anterior wall. † | ||
#Centered on bladder wall (as opposed to the mucosa). | #Centered on bladder wall (as opposed to the mucosa). | ||
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*[[Adenocarcinoma of the urinary bladder]]. | *[[Adenocarcinoma of the urinary bladder]]. | ||
*Invasive [[urothelial carcinoma]] with glandular differentiation. | *Invasive [[urothelial carcinoma]] with glandular differentiation. | ||
*[[Metastatic | *[[Metastatic]] adenocarcinoma/[[adenocarcinoma]] extending from another structure, e.g. [[colorectal adenocarcinoma]]. | ||
*Villous adenoma of the urachus<ref>{{Cite journal | last1 = Joniau | first1 = S. | last2 = Lerut | first2 = E. | last3 = Van Poppel | first3 = H. | title = A Giant Mucinous Adenocarcinoma Arising within a Villous Adenoma of the Urachus: Case Report and Review of the Literature. | journal = Case Rep Med | volume = 2009 | issue = | pages = 818646 | month = | year = 2009 | doi = 10.1155/2009/818646 | PMID = 20182635 }}</ref> - non-invasive. | |||
===Patterns=== | ===Patterns=== | ||
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===Images=== | ===Images=== | ||
<gallery> | <gallery> | ||
Image: | Image: Urachal carcinoma - very low mag.jpg | UC - very low mag. (WC/Nephron) | ||
Image: | Image: Urachal carcinoma - low mag.jpg | UC - low mag. (WC/Nephron) | ||
Image: | Image: Urachal carcinoma - intermed mag.jpg | UC - intermed mag. (WC/Nephron) | ||
Image: Urachal carcinoma - high mag.jpg | UC - high mag. (WC/Nephron) | |||
Image: Urachal carcinoma - very high mag.jpg | UC - very high mag. (WC/Nephron) | |||
</gallery> | </gallery> | ||
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===Sheldon staging system=== | ===Sheldon staging system=== | ||
Staging as Sheldon ''et al.'':<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><ref name=pmid6361280>{{Cite journal | last1 = Sheldon | first1 = CA. | last2 = Clayman | first2 = RV. | last3 = Gonzalez | first3 = R. | last4 = Williams | first4 = RD. | last5 = Fraley | first5 = EE. | title = Malignant urachal lesions. | journal = J Urol | volume = 131 | issue = 1 | pages = 1-8 | month = Jan | year = 1984 | doi = | PMID = 6361280 }}</ref> | Staging as per Sheldon ''et al.'':<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><ref name=pmid6361280>{{Cite journal | last1 = Sheldon | first1 = CA. | last2 = Clayman | first2 = RV. | last3 = Gonzalez | first3 = R. | last4 = Williams | first4 = RD. | last5 = Fraley | first5 = EE. | title = Malignant urachal lesions. | journal = J Urol | volume = 131 | issue = 1 | pages = 1-8 | month = Jan | year = 1984 | doi = | PMID = 6361280 }}</ref> | ||
*pT1 - confined to urachal mucosa. | *pT1 - confined to urachal mucosa. | ||
*pT2 - confined to the urachus. | *pT2 - confined to the urachus. | ||