Anatomical Pathology Interesting Case Conference

Microscopic Description:

Histology reveals cystic lesion lined by urothelial epithelium and adenomatous glands, which was surrounded by mucin pools, blood vessels and fibroconnective tissue.

IHC GATA3-, CK20+.

Discussion:

Urachus connects the bladder to the allantois sac through the umbilicus and obliterates by the end of gestation into a fibrous band forming the umbilical ligament.

Urachal anomalies arises due to failure of complete obliteration of the Urachus.

They are associated with other genitourinary malformations, like Posterior urethral valves/ Prune belly syndrome.

Urachal cyst adenocarcinoma is a rare type of bladder tumor arising from urachal remnant.

Incidental gross hematuria is often the presenting symptom.

Microscopic image possibly detecting cancerous areas in human tissue
References:

Mathew, Emil & Kunnel, Sandra & Devi, Maya & Zachariah, Sanoop. (2023). Laparoscopic Excision of a Symptomatic Urachal Cyst (UC) in an Adult. Cureus. 10.7759/cureus.40846.

Patel J, Villegas A. Urachal Adenocarcinoma: A Rare Primary Cancer Managed With FOLFOX Chemotherapy. Cureus. 2023 Aug 21;15(8):e43849.

Siefker-Radtke A. Urachal adenocarcinoma: a clinician's guide for treatment. Semin Oncol. 2012 Oct;39(5):619-24.

García Chou Chene L, Ballesta B, Rodríguez Talavera J, Morales Orribo N, Carrión A. Urachal Pathology: Review of Cases. Urol Int. 2022;106(2):195-198. doi: 10.1159/000515648. Epub 2021 May 6. PMID: 33957634.

Alyusuf Z, Hassan A, Maki R, Hasan W, Alhamar R. Intravesical urachal cyst masquerading as a bladder malignancy: a case report. J Med Case Rep. 2023 Aug 24;17(1):364.

 

Suartz CV, Martinez LM, Silvestre MHL, Lima RD, Brito PHS, Galhardo KA, Lopes RI, Moraes VHS, Moraes CMT, Covatti L, Azevedo MFD, Almeida LS, Setoue DND, Braz NDSF, Bessa J Júnior, Korkes F, Reis LO, Leite KRM, Nahas WC, Toren P, Ribeiro-Filho LA. Urachal Carcinomas: A Comprehensive Systematic Review and Meta-analysis. Int Braz J Urol. 2025 May-Jun;51(3):e20240665.

 

Kostara K, Palmisano L, Shenasan P, El Sedfy A, Christian D. Urachal adenocarcinoma: a case report and literature review. J Surg Case Rep. 2025 Dec 17;2025(12):rjaf973.

Tegegne CY, Bekele FS, Alene AT, Gebreegziabher KT, Jiffar AD, Ahmed SE. Primary urachal adenocarcinoma treated with partial cystectomy - Case report. Int J Surg Case Rep. 2025 Jun;131:111449.

Case Images