Clinical Analysis Of 9 Cases Of Urichal Carcinoma

Background and purpose: Urachal carcinoma is a rare malignant epithelial tumor originating from urachal residual tissue. Early diagnosis and treatment is relatively difficult due to the hidden origin. Pathological types of urachal carcinoma can be classified as mucous adenocarcinoma and non-mucous adenocarcinoma and there were rare cases of urothelial carcinoma. The aim of this study was to discuss the diagnosis , treatment and outcome of the disease.Methods: 9 cases of urachal carcinoma treated from July 1999 to June 2008 at the tumour hospital of guangxi medical university were reviewed and analyzed. 6 cases were mucinous adenocarcinoma ,1 case was adenocarcinoma and the other two were urothelial carcinoma.Results: The most common complaints of the 9 patients were hematuria and irrigative bladder symptoms.Cystoscopy mainly revealed broad-based tumors located at the dome of the bladder.Soft-tissue masses between the bladder dome and the abdominal wall were detected by imaging examinations;the wall of the bladder was often invaded. Of 9 cases , 2 cases (Stageâ…¢) received partial cystectomy and recurred at 7 or 9 months of post-operation, respectively, the patients died within 1 year after surgery. one advanced cancer patients(Stageâ…£) received chemotherapy , which achieved progression free survival for six months and later died from extensive metastasis after 13 months. Among the 6 cases treated by extensive partial cystectomy, 3 cases( 2 Stageâ…¢and 1 Stageâ…£) died at 1.5 yeaes to 4 years post-operation; the other 3 cases (Stageâ…¢) remained alive up to the last follow-up date, two of them has survived over 5 years.Conclusions: Urachal carcinoma is difficult to be diagnose as due to its special anatomical position. Most of the patients were diagnosed at late stage and had relatively poor prognosis. The most important prognostic factor is the clinical stage. Extensive partial cystectomy might be one of the best treatments for the disease. Radical removal of the tumor during the first treatment and comprehensive therapies for advanced cancer patients and patients with recurrence or metastasis after operation are critical to improve the treatment efficacy of urachal carcinoma.