The organ sparing management of a patient with urachus cancer in conditions of comorbidity

Malignant tumors of the urachus are extremely rare. The frequency of urachal malignancy makes 1: 5 000 000 cases, which is 0.35–1.2 % of all the cases of bladder cancer. The small series of observations described in the literature do not allow us to formulate statistically reliable and unambiguously...

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Main Authors: M. D. Ter-Ovanesov, D. M. Yagudaev, A. A. Gritskevich, A. V. Umyarova, V. A. Bezhenar
Format: Article
Language:Russian
Published: QUASAR, LLC 2024-03-01
Series:Исследования и практика в медицине
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Online Access:https://www.rpmj.ru/rpmj/article/view/916
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author M. D. Ter-Ovanesov
D. M. Yagudaev
A. A. Gritskevich
A. V. Umyarova
V. A. Bezhenar
author_facet M. D. Ter-Ovanesov
D. M. Yagudaev
A. A. Gritskevich
A. V. Umyarova
V. A. Bezhenar
author_sort M. D. Ter-Ovanesov
collection DOAJ
description Malignant tumors of the urachus are extremely rare. The frequency of urachal malignancy makes 1: 5 000 000 cases, which is 0.35–1.2 % of all the cases of bladder cancer. The small series of observations described in the literature do not allow us to formulate statistically reliable and unambiguously recommended statements about the optimal methods of diagnostics and treatment of this pathology. The diagnosis of urachus diseases is often challenging. This is associated with both the asymptomatic course and the variety of clinical flow of the disease. The treatment strategies are also largely ambiguous and ranging from the defining the indications for surgical treatment to the aggressiveness of surgical intervention. Meanwhile, 20 % of patients with urachal cancer have distant metastases at the time of detection. With everything listed above, (low frequency, little research done and aggressiveness of the flow) it makes every clinical observation of this disease valuable.This article is a clinical observation providing with the information upon the diagnosis, the choice of strategies and surgical treatment of urachal cancer in a patient suffering from multimorbidity. Volumetric formation of the bladder was detected in this patient during additional examination for macrohematuria. Cystoscopy with transurethral resection and subsequent morphological examination verified invasive mucinous adenocarcinoma of the bladder with the growth into the lamina propria and without the signs of vascular and perineural invasion. The patient underwent laparotomy, radical resection of the bladder with extended pelvic lymphadenectomy. The umbilicus, urachus and the bladder wall with the tumor, as well as the adjacent peritoneum, were excised as a single block during the surgical intervention. Morphological examination verified mucinous adenocarcinoma of urachus. The postoperative period was uneventful.There have been no signs of disease progression observed during 10-month follow-up period.
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spelling doaj-art-7888127bfd5a48398339e8f23b9b7a6d2025-08-20T03:22:00ZrusQUASAR, LLCИсследования и практика в медицине2410-18932024-03-01111707710.17709/2410-1893-2024-11-1-6528The organ sparing management of a patient with urachus cancer in conditions of comorbidityM. D. Ter-Ovanesov0D. M. Yagudaev1A. A. Gritskevich2A. V. Umyarova3V. A. Bezhenar4Central Clinical Hospital «RZhD-Medicine»<p> Moscow, Russian Federation <p> A. I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation<p> Moscow, Russian FederationCentral Clinical Hospital «RZhD-Medicine»<p> Moscow, Russian Federation <p> Peoples Friendship University of Russia (RUDN University)<p> Moscow, Russian FederationPeoples Friendship University of Russia (RUDN University)<p> Moscow, Russian Federation <p> A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation<p> Moscow, Russian FederationPeoples Friendship University of Russia (RUDN University)<p> Moscow, Russian FederationCentral Clinical Hospital «RZhD-Medicine»<p> Moscow, Russian FederationMalignant tumors of the urachus are extremely rare. The frequency of urachal malignancy makes 1: 5 000 000 cases, which is 0.35–1.2 % of all the cases of bladder cancer. The small series of observations described in the literature do not allow us to formulate statistically reliable and unambiguously recommended statements about the optimal methods of diagnostics and treatment of this pathology. The diagnosis of urachus diseases is often challenging. This is associated with both the asymptomatic course and the variety of clinical flow of the disease. The treatment strategies are also largely ambiguous and ranging from the defining the indications for surgical treatment to the aggressiveness of surgical intervention. Meanwhile, 20 % of patients with urachal cancer have distant metastases at the time of detection. With everything listed above, (low frequency, little research done and aggressiveness of the flow) it makes every clinical observation of this disease valuable.This article is a clinical observation providing with the information upon the diagnosis, the choice of strategies and surgical treatment of urachal cancer in a patient suffering from multimorbidity. Volumetric formation of the bladder was detected in this patient during additional examination for macrohematuria. Cystoscopy with transurethral resection and subsequent morphological examination verified invasive mucinous adenocarcinoma of the bladder with the growth into the lamina propria and without the signs of vascular and perineural invasion. The patient underwent laparotomy, radical resection of the bladder with extended pelvic lymphadenectomy. The umbilicus, urachus and the bladder wall with the tumor, as well as the adjacent peritoneum, were excised as a single block during the surgical intervention. Morphological examination verified mucinous adenocarcinoma of urachus. The postoperative period was uneventful.There have been no signs of disease progression observed during 10-month follow-up period.https://www.rpmj.ru/rpmj/article/view/916urachal cancerresection of the bladdermucinous adenocarcinoma of urachus
spellingShingle M. D. Ter-Ovanesov
D. M. Yagudaev
A. A. Gritskevich
A. V. Umyarova
V. A. Bezhenar
The organ sparing management of a patient with urachus cancer in conditions of comorbidity
Исследования и практика в медицине
urachal cancer
resection of the bladder
mucinous adenocarcinoma of urachus
title The organ sparing management of a patient with urachus cancer in conditions of comorbidity
title_full The organ sparing management of a patient with urachus cancer in conditions of comorbidity
title_fullStr The organ sparing management of a patient with urachus cancer in conditions of comorbidity
title_full_unstemmed The organ sparing management of a patient with urachus cancer in conditions of comorbidity
title_short The organ sparing management of a patient with urachus cancer in conditions of comorbidity
title_sort organ sparing management of a patient with urachus cancer in conditions of comorbidity
topic urachal cancer
resection of the bladder
mucinous adenocarcinoma of urachus
url https://www.rpmj.ru/rpmj/article/view/916
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