URACHAL ADENOCARCINOMA, OUR EXPERIENCE IN 20 YEARS

OBJECTIVE: To report two cases of urachal adenocarcinoma and to review the published literature. METHODS / RESULTS: We present a review of our urachal carcinoma cases from a third level hospital between 19902011 in an area of 520.000 inhabitants. Both cases were middle aged men, consulting for repeated urine infections, and abdominal mass with hematuria and mucous discharge through the urethra. They were treated initially with partial cystectomy and adjuvant treatment with chemotherapy in one case, and chemo and radiotherapy in the other. The first case died in 3 years and the other is still alive after 4 years of follow up. CONCLUSIONS: Urachal adenocarcinomas of the bladder are rare tumors the natural history of which has not changed during the last years. Open partial cystectomy with en bloc resection of the bladder dome, urachus and the umbilicus is the standard treatment in localized stages, although minimal invasive techniques appear to have the same oncological outcomes. Pelvic lymphadenectomy is advised. Most of the patients are diagnosed at an advanced local or metastatic stage. There is a need to improve diagnostic techniques for early treatment and to find new chemotherapy protocols that can help to improve these patients' survival.