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Case Reports in Medicine
Volume 2009, Article ID 818646, 4 pages
http://dx.doi.org/10.1155/2009/818646
Case Report

A Giant Mucinous Adenocarcinoma Arising within a Villous Adenoma of the Urachus: Case Report and Review of the Literature

1Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
2Department of Pathology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium

Received 9 July 2009; Accepted 14 December 2009

Academic Editor: Jonathan Melamed

Copyright © 2009 Steven Joniau et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We present an exceptional case of a giant urachal tumor, consisting of both villous adenoma and mucinous adenocarcinoma of the urachus. The tumor was incidentally discovered during investigations for renal failure. Initial transurethral biopsies showed only a villous adenoma of the urachus. Although the biopsies showed no malignancy, a radical cystoprostatectomy and broad excision of the urachus and umbilicus were performed. At the same time, a bilateral nephroureterectomy was performed because of reflux-nephropathy and renal failure. The indication for surgery was based on the typical imaging aspects, raising the suspicion of an underlying urachal adenocarcinoma (size and location). Indeed, at final histopathology a concomitant well-differentiated adenocarcinoma of the urachus confined to the urachal mucosa was found. The patient remained free of disease for 50 months of follow-up. Only three previous cases of urachal adenocarcinoma associated with villous adenoma have been described.