DOCSLIB.ORG

Download Download

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Download Download EDITORIAL Evolution of the CUA guideline – Raising the bar! PARTNERS NOW & Anil Kapoor, MD n this issue of CUAJ, we publish a Best Practice Report or BPR on chronic scrotal pain. Unlike a comprehensive Canadian Urological Association (CUA) guideline, these CUA CUAJ Associate Editor IBPRs will provide a summary of the best evidence available on common urological and Professor of Surgery topics to help guide management decisions. Jarvi et al have given us some great direction INTO THE FUTURE (Urology), McMaster in the medical and invasive management of chronic scrotal pain, a challenging patient University, Hamilton, ON, issue many urologists deal with in their practice. We have further BPRs in development Canada on topics including imaging in prostate cancer, management of hemorrhagic cystitis, and management of the large sporadic angiomyolipoma. If you have any other suggestions for topics relevant to common urological practice, please send them along to us! Cite as: Can Urol Assoc J 2018;12(6):151. http://dx.doi.org/10.5489/cuaj.5409 The CUA Guidelines Committee (GC) has also been busy developing comprehensive Platinum Corporate guidelines for our membership. Recent guidelines on prostate cancer screening, antenatal Sponsor of the 73 rd hydronephrosis, circumcision, and Peyronie’s disease have been well-received. Thank Annual Meeting of you to the authors of these guidelines for their time and commitment. These guidelines the CUA and their summary slides are available for review and download at cua.org and cuaj.ca. Guidelines due to be published shortly include the updated male lower urinary tract symptoms/benign prostatic hyperplasia guideline, updated kidney cancer followup guide- line, and incidental adrenal mass guideline. The CUA GC has also established a col - laboration with Cochrane for methodological support for future guidelines, as well as a collaboration with the American Urological Association on an updated urinary tract infection guideline. Dr. Gerald Brock CUAJ has also published a number of consensus statements, which also provide direc- CUA President tion to our membership on management of urological conditions, based on the best evidence available. Recent consensus statements include the Kidney Cancer Research Network of Canada (KCRNC)-CUA consensus on the management of advanced kidney cancer and current evidence for adjuvant therapy in high-risk resected kidney cancer. Due to be published shortly are the Genitourinary Medical Oncologists of Canada (GUMOC)- Special CUA CUA consensus on management of urachal cancer. Guideline Session The CUA GC recently held a workshop to review the GRADE level of evidence and Halifax Convention Centre, transition from the Oxford system to GRADE. Guest speakers Dr. Philipp Dahm, Dr. Room: Ballroom 3 Shahnaz Sultan, and Dr. Philippe Violette ran a great session, walking urologists through Chair, Dr. Anil Kapoor the GRADE process. Future guidelines will be in the GRADE format and topics in develop- Tuesday, June 26, 2018 ment include urethral stricture disease and updated asymptomatic microscopic hematuria. 13:05–14:05 GRADE was developed in 2000 and has become the preferred grading system based upon a common sense and transparent approach to grading quality of evidence. Any CUA Venous thromboembolism member who would like to learn more about GRADE can view the entire workshop in prophylaxis the members-only section of the CUA website (cua.org). Further information on GRADE Non-metastatic renal cell is also available at gradeworkinggroup.ca. carcinoma followup We at the CUA and CUAJ hope these guidelines, BPRs, and consensus statements are useful to your practice and any feedback is always welcome. See you in Halifax at the Peyronie’s disease and annual CUA meeting and enjoy your summer! congenital penile curvature Correspondence: Dr. Anil Kapoor, McMaster University, Hamilton, ON, Canada; [email protected] UROLOGY ONCOLOGY CUAJ • June 2018 • Volume 12, Issue 6 151 © 2018 Canadian Urological Association AST20111_01A_CUA_Journal_ad.indd 1 2018-05-17 2:13 PM AST20111-01A _CUA _ Journal_ ad 1 2 AST20111-01 CUA 2018 Journal Feilin Fu CMYK Myrbetriq – Journal ad 8.125" x 10.875" 100% AST20111-01A DF 05/17/18 Astellas James Graham 7" x 9.5" PMS PMS PMS PMS PMS FOIL Grace Debrabandere 0.125" 100%.
Load more

Recommended publications
  • A Rare Case of Urachal Adenocarcinoma with Bone Marrow Metastasis Joshua Van Allen1,2
    Case report BMJ Case Rep: first published as 10.1136/bcr-2021-242315 on 15 April 2021. Downloaded from A rare case of urachal adenocarcinoma with bone marrow metastasis Joshua Van Allen1,2 1Department of Medicine, SUMMARY non-urachal adenocarcinomas whose median age is University of Connecticut Health Urachal cancer is a rare and aggressive cancer that often around 69 years old.10 14 Urachal cancer also displays Center, Farmington, Connecticut, presents in advanced stages. Given the rarity of this male predilection, with males representing between USA 7 8 2 malignancy, medical case studies provide one of the few 60% and 68% of all cases. Hartford HealthCare Cancer Patients with urachal cancer often present Institute at The Hospital of sources of literature available through which clinicians with locally advanced or metastatic disease, most Central Connecticut, Plainville, can guide medical management. Surgery is widely Connecticut, USA considered to be the mainstay of therapy when disease commonly metastatic to the lungs, liver, perito- is localised and surgically resectable, therefore most neum, lymph nodes, brain and/or bone.6 8 12 13 Correspondence to current case studies on urachal cancer focus on surgical Given the aggressive nature of urachal cancer, early Dr. Joshua Van Allen; management, occasionally with adjuvant chemotherapy. diagnosis is paramount as there is significant diver- jvanallen@ uchc. edu However, few case studies discuss chemotherapy alone gence in both treatment and prognosis depending in the treatment of metastatic disease. Most studies on stage. A retrospective study performed by Accepted 6 April 2021 indicate a median overall survival between 12 and 24 Mayo Clinic in Rochester, Minnesota evaluated 49 months for metastatic urachal adenocarcinoma.
    [Show full text]
  • Mutations of KRAS, NRAS, BRAF, EGFR, and PIK3CA Genes in Urachal Carcinoma: Occurence and Prognostic Significance
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Jagiellonian Univeristy Repository www.impactjournals.com/oncotarget/ Oncotarget, Vol. 7, No. 26 Research Paper: Pathology Mutations of KRAS, NRAS, BRAF, EGFR, and PIK3CA genes in urachal carcinoma: Occurence and prognostic significance Orsolya Módos1, Henning Reis2, Christian Niedworok3, Herbert Rübben3, Attila Szendröi1, Marcell A. Szász4, József Tímár4, Kornélia Baghy5, Ilona Kovalszky5, Tomasz Golabek6, Piotr Chlosta6, Krzysztof Okon7, Benoit Peyronnet8, Romain Mathieu8, Shahrokh F. Shariat9, Péter Hollósi5,10, Péter Nyirády1 and Tibor Szarvas1,3 1 Department of Urology, Semmelweis University, Budapest, Hungary 2 Institute of Pathology, University of Duisburg-Essen, Essen, Germany 3 Department of Urology, University of Duisburg-Essen, Essen, Germany 4 2nd Department of Pathology, Semmelweis University, Budapest, Hungary 5 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary 6 Department of Urology, Jagiellonian University, Krakow, Poland 7 Department of Pathomorphology, Jagiellonian University, Krakow, Poland 8 Department of Urology, Rennes University Hospital, Rennes, France 9 Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria 10 Tumor Progression Research Group, Hungarian Academy of Sciences, Budapest, Hungary Correspondence to: Tibor Szarvas, email: [email protected] Keywords: urachal carcinoma, urachal cancer, urachus, mutation, EGFR, Pathology Section Received: April 08, 2016 Accepted: May 29, 2016 Published: June 05, 2016 ABSTRACT Purpose: Targeted therapy represents an attractive alternative for rare tumors such as urachal carcinoma (UrC). The aim of this study was to assess the mutations of the most commonly affected 5 genes in the targetable EGFR-pathway in UrC and comapre their frequencies to those of found in urothelial and colorectal cancer.
    [Show full text]
  • UEMS 2020.11 Syllabus of the ETR in Rare Adult Cancers
    UNION EUROPÉENNE DES MÉDECINS SPÉCIALISTES EUROPEAN UNION OF MEDICAL SPECIALISTS Association internationale sans but lucratif International non-profit organisation RUE DE L’INDUSTRIE, 24 T +32 2 649 51 64 BE- 1040 BRUSSELS F +32 2 640 37 30 www.uems.eu [email protected] UEMS 2020.11 Syllabus for residents and trainees in Rare Adult Solid Cancers The basic goal of this syllabus is to provide an understanding between the instructor and trainee so there is minimal confusion in the topics, with clear expectations. It is not a classical syllabus as it contains descriptions from different areas, but it still summarizes major and specific topics that should be covered during the training course of a resident. This syllabus is intended as supporting reference material, and the precise content and priorities of training may vary in different training institutions. The syllabus can also be modified to reflect each instructor's teaching philosophy towards the trainees. 1. There are scientific publications, web pages, and conference materials available online that could be used for educational purposes for various types of rare adult solid cancers. This is a comprehensive summary of them. 2. There are significant differences in the number of available scientific publications and reviews for different rare adult solid cancers. Some, like sarcomas, have a very robust literature, while others have been sparsely researched and consequently the availability of study materials is quite poor. 3. These differences also apply to life events and natural history. In the list of the EU CE accredited events there is a strong underrepresentation for some types of rare adult solid cancers.
    [Show full text]
  • Urachal Cancer in Pregnancy: a Case Report Genel H1, Hubinont C2, Baldin P3, Amant F4-6 and and Review of Literature Mhallem M1*
    Case Report iMedPub Journals Gynaecology & Obstetrics Case report 2020 www.imedpub.com ISSN 2471-8165 Vol.6 No.2:17 DOI: 10.36648/2471-8165.6.2.97 Urachal Cancer in Pregnancy: A Case Report Genel H1, Hubinont C2, Baldin P3, Amant F4-6 and and Review of Literature Mhallem M1* 1 Department of Obstetrics, Cliniques Universitaires, Saint-Luc, Belgium Abstract 2 Department of Urology, Cliniques We report a case of an urachal cancer during pregnancy. The patient was referred Universitaires, Saint-Luc, Belgium at 38 weeks pregnancy for suspicion of placenta accreta spectrum (PAS). The only 3 Departement of Pathology, Cliniques symptom was a macroscopic hematuria during the third trimester. Obstetrical Universitaires, Saint-Luc, Belgium ultrasound in tertiary center suggested a bladder tumor. A polyp was observed 4 Department of Oncology, Kuleuven, at the vesical dome during the cystoscopy. After the delivery and computed Belgium tomography, the patient underwent a tumor resection with high suspicion of 5 Center for Gynecological Oncology urachal cancer. A radical cystectomy and enteroplasty were performed. The Amsterdam (CGOA), Anton Van pathological findings confirmed the urachal origin of the lesion. Leeuwenhoek Cancer Institute, The Netherlands Keywords: Urachal cancer; Ultrasound; Pregnancy 6 Center for Gynecological Oncology Amsterdam (CGOA), Amsterdam University, Medical Centers, The Received: April 16, 2020; Accepted: June 01, 2020; Published: June 05, 2020 Netherlands Introduction *Corresponding author: Mhallem M Urachal cancer is a form of cancer that arises in a structure called the urachus. The urachus is a canal that exists when the fetus is [email protected] developing before birth. This canal runs from the bladder of the fetus to the belly button (umbilicus).
    [Show full text]
  • Evicore Oncology Imaging Guidelines
    CLINICAL GUIDELINES Oncology Imaging Policy Version 1.0 Effective February 14, 2020 eviCore healthcare Clinical Decision Support Tool Diagnostic Strategies: This tool addresses common symptoms and symptom complexes. Imaging requests for individuals with atypical symptoms or clinical presentations that are not specifically addressed will require physician review. Consultation with the referring physician, specialist and/or individual’s Primary Care Physician (PCP) may provide additional insight. CPT® (Current Procedural Terminology) is a registered trademark of the American Medical Association (AMA). CPT® five digit codes, nomenclature and other data are copyright 2017 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in the CPT® book. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for the data contained herein or not contained herein. © 2019 eviCore healthcare. All rights reserved. Oncology Imaging Guidelines V1.0 Oncology Imaging Guidelines Abbreviations for Oncology Guidelines 3 ONC-1: General Guidelines 5 ONC-2: Primary Central Nervous System Tumors 18 ONC-3: Squamous Cell Carcinomas of the Head and Neck 33 ONC-4: Salivary Gland Cancers 40 ONC-5: Melanomas and Other Skin Cancers 47 ONC-6: Thyroid Cancer 60 ONC-7: Small Cell Lung Cancer 68 ONC-8: Non-Small Cell Lung Cancer 75 ONC-9: Esophageal Cancer 83 ONC-10: Other Thoracic Tumors 90 ONC-11: Breast Cancer 100 ONC-12: Sarcomas – Bone, Soft Tissue
    [Show full text]
  • D8.2 Report Summarizing the Status of the Development of UEMS-EU Harmonized Educational Principles
    Ref. Ares(2019)2255680 - 29/03/2019 “This Deliverable is a part of the joint action “724161/JARC” which has received funding from the European Union’s Health Programme (2014-2020)”. “The content of this Deliverable represents the views of the authors only and they are sole responsibility: it can not be considered to reflect the views of the European Commission and or the Country, Health, Agriculture and Food Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may of the information it contains”. Deliverable no: D8.2 Title: Report summarizing the status of the development of UEMS-EU harmonized educational principles and recommended training materials for rare cancers 1 Table of contents 1. Description 3 1.1 The Joint Action on Rare Cancers 3 1.2 Work Package X 3 1.3 Aim and purpose of deliverable 3 1.4 The target group of the specific deliverable 4 1.5 Summary of the main conclusions of the deliverable 4 2. Introduction 4 3. Material and method 4 4. Results 4 5. Discussion 4 2 Table of contents 1. Description 1.1 The Joint Action on Rare Cancers Description The Joint Action on Rare Cancers (JARC) is aimed to integrate and maximize efforts of the European Union (EU) Commission, EU Member States and all stakeholders to advance quality of care and research on rare cancers. The public health challenges posed by rare cancers include the limited professional expertise in the community, the difficulties in clinical research, the need of a timely and appropriate diagnosis and optimal treatment from the very beginning of the patient’s journey.
    [Show full text]
  • Review Article Biomarkers in Urachal Cancer and Adenocarcinomas in the Bladder: a Comprehensive Review Supplemented by Own Data
    Hindawi Disease Markers Volume 2018, Article ID 7308168, 21 pages https://doi.org/10.1155/2018/7308168 Review Article Biomarkers in Urachal Cancer and Adenocarcinomas in the Bladder: A Comprehensive Review Supplemented by Own Data 1 2 2 3 1 Henning Reis , Ulrich Krafft, Christian Niedworok, Orsolya Módos, Thomas Herold, 4 5 2 3 Mark Behrendt, Hikmat Al-Ahmadie, Boris Hadaschik, Peter Nyirady, 2,3 and Tibor Szarvas 1Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany 2Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany 3Department of Urology, Semmelweis University, Üllői út 78/b, 1082 Budapest, Hungary 4Department of Urology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, Netherlands 5Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA Correspondence should be addressed to Henning Reis; [email protected] Received 25 July 2017; Accepted 6 February 2018; Published 12 March 2018 Academic Editor: Tilman Todenhöfer Copyright © 2018 Henning Reis 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. Urachal cancer (UrC) is a rare but aggressive cancer. Due to overlapping histomorphology, discrimination of urachal from primary bladder adenocarcinomas (PBAC) and adenocarcinomas secondarily involving the bladder (particularly colorectal adenocarcinomas, CRC) can be challenging. Therefore, we aimed to give an overview of helpful (immunohistochemical) biomarkers and clinicopathological factors in addition to survival analyses and included institutional data from 12 urachal adenocarcinomas.
    [Show full text]
  • Metastatic Urachal Cancer Treated Effectively with Gemcitabine/Cisplatin Combination Chemotherapy and Radiotherapy: a Case Report
    MOLECULAR AND CLINICAL ONCOLOGY 11: 139-142, 2019 Metastatic urachal cancer treated effectively with gemcitabine/cisplatin combination chemotherapy and radiotherapy: A case report HIROSHI YAEGASHI, SUGURU KADOMOTO, RENATO NAITO, TOMOYUKI MAKINO, HIROAKI IWAMOTO, TAKAHIRO NOHARA, KAZUYOSHI SHIGEHARA, KOUJI IZUMI, YOSHIFUMI KADONO and ATSUSHI MIZOKAMI Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan Received December 13, 2018; Accepted May 16, 2019 DOI: 10.3892/mco.2019.1865 Abstract. Urachal cancer often presents at an advanced Because of the silent nature of early lesions, their propensity stage with poor prognosis due to the lack of an effective for local growth and the tendency to metastasize late in systematic therapeutic strategy. We experienced a case of the clinical course, a large proportion of patients with UrC metastatic urachal cancer treated effectively by combina- present with disease at the pT3 stage: Local extension to the tion chemotherapy and radiotherapy. A 55-year-old female (a) bladder, (b) abdominal wall, (c) viscera other than the presented to our department with right lower abdominal pain. bladder, or higher (1). A transurethral biopsy of an urachal tumor suggested urachal UrC consisted of well differentiated tumors, and adenocarcinoma. The patient underwent chemotherapy with non-involvement of adjacent organs and the peritoneum gemcitabine and cisplatin for metastatic urachal cancer. As indicates better prognosis when treated operatively (3), tumor markers declined and the radiological findings indi- however, there have been lack of evidence for advanced UrC. cated stability of disease, external beam radiotherapy was Furthermore, a recurrent rate is very high in patient with then administered to the primary site.
    [Show full text]
  • Primary Urachal Adenocarcinoma: a Case Report
    African Journal of Urology (2014) 20, 95–98 Pan African Urological Surgeons’ Association African Journal of Urology www.ees.elsevier.com/afju www.sciencedirect.com Case Report Primary urachal adenocarcinoma: A case report I. Ziouziou ∗, T. Karmouni , K. El Khader , A. Koutani , A. Iben Attya Andaloussi Service d’urologie B, hôpital Ibn Sina, Rabat, Morocco Received 25 November 2013; received in revised form 25 November 2013; accepted 8 February 2014 KEYWORDS Abstract Urachus; Primary urachal adenocarcinoma is an aggressive rare cancer that often presents at advanced stages with Adenocarcinoma; poor prognosis. We report this case of a 52-year-old patient with a stage-I (Mayo Clinic) primary urachal ade- Bladder nocarcinoma with good outcomes after surgery in a 2-year follow-up period. We analyze epidemiological, clinical and therapeutic features of this disease in the literature review. © 2014 Pan African Urological Surgeons’ Association. Production and hosting by Elsevier B.V. All rights reserved. Introduction Case report Primary urachal adenocarcinoma is a rare and aggressive cancer. It Mr. M.A., a 52-year-old patient, had a history of epileptic disease often presents at an advanced stage and has a poor prognosis. We treated by tegretol. He had a total intermittent hematuria and irri- report the case of a 52-year-old patient with a stage I (Mayo Clinic) tative urinary symptoms for a month. Clinical examination was primary urachal adenocarcinoma with good outcomes after surgery normal. Ultrasound revealed an echogenic mass localized in the with a follow-up of 2 years. We analyze epidemiological, clinical anterior wall of bladder.
    [Show full text]
  • The Journal of Urology
    The Journal of Urology Volume 178, Issue 1, Pages 1-364 (July 2007) 1. This Month in Clinical Urology Pages 1-3 Martin I. Resnick 2. This Month in Pediatric Urology Pages 5-6 Jack S. Elder 3. This Month in Investigative Urology Pages 7-8 Anthony Atala Editorials 4. Getting Through it All Page 9 Martin I. Resnick 5. β2 Microglobulin: A Surprising Therapeutic Target for Prostate Cancer and Renal Cell Carcinoma Pages 10-11 Michael R. Freeman 6. Upper Urinary Tract Cancer—Challenges for the Urologist Pages 12-13 Peter J. Bostrom and Mark S. Soloway 7. Evaluation of Nitrous Oxide Anesthesia for Endoscopic and Laparoscopic Urological Applications Page 14 Jaime Landman Review Articles 8. Techniques for Fluoroscopic Percutaneous Renal Access Pages 15-23 Nicole L. Miller, Brian R. Matlaga and James E. Lingeman 9. The Comparative Safety of Oral Versus Intranasal Desmopressin for the Treatment of Children With Nocturnal Enuresis Pages 24-30 W.L.M. Robson, A.K.C. Leung and J.P. Norgaard Historical Article 10. The Circumcision of Jesus Christ Pages 31-34 Johan J. Mattelaer, Robert A. Schipper and Sakti Das Adult Urology Oncology: Adrenal/Renal/Upper Tract/Bladder 11. Prognostic Impact of Tumor Size on pT2 Renal Cell Carcinoma: An International Multicenter Experience Pages 35-40 Tobias Klatte, Jean-Jacques Patard, Rakhee H. Goel, Mark D. Kleid, Francois Guille, Bernard Lobel, Clement-Claude Abbou, Alexandre De La Taille, Jacques Tostain, Luca Cindolo, et al. 12. Editorial Comment Page 40 Peter E. Clark 13. Reply by Authors Page 40 14. Comparison of 1,800 Laparoscopic and Open Partial Nephrectomies for Single Renal Tumors Pages 41-46 Inderbir S.
    [Show full text]
  • Case Report: Bladder Adenocarcinoma: Primary Or Urachal? [Version 1; Peer Review: 2 Approved, 1 Approved with Reservations, 1 Not Approved]
    F1000Research 2019, 8:1717 Last updated: 28 JUL 2021 CASE REPORT Case Report: Bladder adenocarcinoma: primary or urachal? [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] J. Eduardo Tejeda-Mariaca1-3, Marco Ordoñez-Alcantara1,3, Aldo Bello-Sedano1,4, Victor Perez-Cornejo1,4, J. Antonio Grandez-Urbina 5 1Urology Deparment, Hospital Nacional Alberto Sabogal Sologuren, Callao, 07001, Peru 2Uroscience Research Group, Lima, 15046, Peru 3Universidad Nacional Mayor de San Marcos, Lima, Peru 4Biomedical Research Institute, Universidad Ricardo Palma, Santiago de Surco, Lima, 15039, Peru 5Universidad Continental, Miraflores, Lima, 15046, Peru v1 First published: 04 Oct 2019, 8:1717 Open Peer Review https://doi.org/10.12688/f1000research.20106.1 Latest published: 04 Oct 2019, 8:1717 https://doi.org/10.12688/f1000research.20106.1 Reviewer Status Invited Reviewers Abstract Background: Bladder adenocarcinoma (AC) is a scarce histological 1 2 3 4 variant and there are few studies on its proper management. No previous case reports present the management of a urachal tumor version 1 and the incidental finding of bladder adenocarcinoma. 04 Oct 2019 report report report report Clinical case: We present the case of a young woman with nonspecific symptoms, who presented with a prior history of dysuria, bladder 1. Orsolya Módos, Semmelweis University, tenesmus, suprapubic pain and urinary urgency for one year, which had been treated as recurrent urinary tract infection. A partial Budapest, Hungary cystectomy plus extended lymphadenectomy was scheduled. We 2. Marlon Perera, Princess Alexandra Hospital, found a bladder tumor with characteristics of a urachal tumor and the pathological report indicated a primary bladder AC.
    [Show full text]
  • An Unusual Presentation of Urachal Tumour
    An unusual presentation of Urachal Tumour Ruth Reeve & Laura Durdle Advanced Practitioner Sonographers, Portsmouth Hospitals NHS Trust Background Anatomy There are only around 350 cases of Urachal cancer described in The urachus is the fibrous remnant or the allantois, a canal that drains the medical literature to date, accounting for 0.2% of all bladder the urinary bladder of the fetus along with the umbilical cord. Failure cancers. of the inside of the urachus to be filled leaves the urachus open. Urachal cancer is a rare type of cancer arising from the urachus There are four anatomical causes: or its remnants. It is often difficult to diagnose and requires a • Cyst multidisciplinary approach. • Fistula • Diverticulum Tumours generally present late with symptoms including: • Sinus -Haematuria The urachus is also subject to -Local pain/swelling neoplasic change -UTI’s -Umbilical discharge Patients who present with early confined disease have a good prognosis. Those with advanced disease have less promising outcomes. Case Report Role of Ultrasound for Management of Patient details: 40 year old Female with no previous Indeterminate Pelvic Masses imaging Clinical history: unprovoked right shoulder pain Differentials for pelvic masses. st 1 Investigation: Shoulder x-ray Leiomyoma (Fibroid) Ovarian Fibroma Ectopic Pregnancy Findings: The humeral head and proximal humeral shaft shows Ovarian Malignancy patchy bone texture with periosteal reaction suggesting a diffuse permeative destructive process. Malignancy suspected 2nd investigation: CT Chest/Abdomen/Pelvis with Contrast Report: Applied to the urinary bladder is a well defined 5.5 cm mass with mixed density contents and a calcified rim - Possible dermoid although there is a possibility of malignant potential ColonColonic Carcinoma Mass Bladder Malignancy considering bone metastasis.
    [Show full text]