A Rare Case of Metastatic Squamous Urachal Carcinoma
S. Andrei, A. Andrei, G. Rusu Muntean, M. Ungureanu, V. Herlea, G. Becheanu, I. PopescuImage Quiz for surgeons, no. 2, 2013
Squamous cell carcinoma is a very rare type of urachal
malignancy, only a few cases being reported in the medical
literature. We present the case of a 49-year-old male patient
diagnosed with infected squamous cell urachal carcinoma
with multiple pulmonary metastases, after complaints of
lower abdominal pain, abdominal mass and fever, without
respiratory symptoms. The abdominal ultrasonography and
the CT scan revealed a tumoral mass in the lower abdomen
in contact with the abdominal wall and the urinary bladder
dome, displacing the small bowel. Pulmonary nodular
lesions were described in the left lobe pyramid. The intraoperative
diagnosis was necrotic urachal tumor with urinary
bladder dome invasion and suspected pulmonary metastases,
and tumor ablation with bladder dome resection and suture
of the bladder were performed. The histopathological result
was poorly differentiated squamous cell carcinoma (G3),
with negative resection margins. The patient recovered well
after surgery, but the prognosis is very poor due to the
metastatic stage in which the tumor was diagnosed, no standard
chemotherapy regimen for the treatment of metastatic urachal
carcinoma being known as effective until now.



