Urachal mucinous adenocarcinoma

Abstract

Introduction: The urachus or omphalomesenteric duct is an embryonic structure connecting the midgut and the yolk sac, which regresses before the third trimester of pregnancy.Objective: To report a case with a diagnosis of urachal adenocarcinoma, a rare malignant neoplasm.Case report: A 50-year-old patient with no pathological history, who had an initial clinical condition of ascites and abdominal pain. At physical examination, we found a palpable mass in the left hypochondrium – iliac fossa, which revealed a mass next to to the bladder dome and anterior wall on the abdominal tomography of the abdomen. The biopsy result reported a mucinous adenocarcinoma of the omphalomesenteric duct (urachal). At the time of diagnosis, the patient was in stage IVB according to the Sheldon et al system and IV according to the Mayo system, an advanced stage of the disease that determines poor prognosis. Treatment with neoadjuvant and surgical chemotherapy was established and  adjuvant chemotherapy to follow, which currently continues with a stable evolution.Conclusions: This is a rare neoplasm. Suspecting its diagnosis will lead to an early diagnosis, which will improve the prognosis and survival of affected patients. Keywords: urachal adenocarcinoma; omphalomesenteric adenocarcinoma, omphalomesenteric duct; mucinous adenocarcinoma.