Abstract

Tumors of the urachus make up less than 1% of the bladder neoplasia and approximately 20 to 35% of bladder adenocarcinomas. At present, little is known of the pathology. Etiology and pathogenesis are still uncertain and risk factors for those tumors have not been identified.
Clinical case: A 41-year-old man came to the urology service due to gross hematuria with no clot formation, accompanied by pain in the hypogastrium. Physical examination revealed an abdomen with a slightly increased volume in the hypogastrium. A mobile, nonpainful, mildly indurated tumor dependent on the umbilicus, measuring approximately 5 cm and not fixed to the deep planes was palpated. Abdominopelvic tomography identified a urinary bladder with wall thickening and a heterogeneous, irregular image measuring 38 x 27 mm at the midline, with punctiform peripheral calcifications. Cystoscopy showed a solid tumor in the bladder dome with a diameter of 3 cm, brown areas, and irregular edges. Treatment was transurethral resection of the bladder, with satisfactory results.
Conclusions: Carcinoma of the urachus is a rare alteration and most information on it comes from case reports and case series. The treatment of choice is partial cystectomy and en bloc resection of the urachus, which has provided good results and progression- free survival rates from 40 to 60%, depending on the type of procedure performed.

Keywords

carcinoma, urachus, cystectomy, partial cystectomy, hypogastrium, abdominopelvic tomography, tumor, glycosuria, proteinuria, hemoglobin