Fact-sheet: Urachal carcinoma


Updated on 09/01/2022 at 5:17 PM

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Definition

Extremely rare cancer (0.01% of all adult cancers), occurring mainly in the 5th and 6th decades

Clinical features

Preferential location at the bladder dome or supravesical region. Presents mainly as a bladder tumor, very rarely as an anterior extraperitoneal or umbilical mass

Presenting signs (relatively late)

  • Hematuria
  • Signs of bladder irritation
  • Hypogastric pain
  • Suprapubic mass
  • Mucoid urinary secretions
  • Umbilical fistula
  • Distant metastases
  • General deterioration

Ultrasound

First-line examination, particularly in the presence of hematuria

Allows assessment of the relationship between the mass and the bladder dome wall and the presence of any endovesical tumor bud; also useful for follow-up

Supravesical, midline mass, more often heterogeneous. Cystic areas +++. Peripheral calcifications frequent (50-70% of cases)

CT

Allows localization of the lesion relative to the bladder, in the space of Retzius, in the midline (typical)

Mass (60%) / multiple hypodense areas (unchanged after contrast injection) = mucus + tissue-density areas that enhance

Calcifications (very frequent and pathognomonic)

Extension toward:

  • the bladder dome
  • the peri- and supravesical fat
  • the sigmoid colon
  • the anterior abdominal wall
  • the lymph node structures

MRI

heterogeneous signal

T1 hypointense and T2 hyperintense signal

heterogeneous enhancement