About the urachus and its pathology. A clinical case of urachus tumor

Urachus diseases represent a relatively rare kind of affliction in child or adult abdominal or urological surgical pathology. The preservation of the urachus lumen leads to rare afflictions, noticed mostly after birth or when they become clinically manifest by various complications. More often than not, these pathological entities require surgical interventions (if the urachal lumen does not close by itself), consisting of partial or total excision of the urachus. Tumor pathology is mostly malign, to a large extent represented by urachus adenocarcinoma. Its initial symptomatology is scarce and confusing. Its treatment is mainly by surgery and consists of the surgical excision of the urachal ligament, of the umbilicus, of a part of the front abdominal wall and partial or total cystectomy, as necessary. The prognosis is unfavourable, since urachal adenocarcinoma is deemed to be a particularly aggressive tumor, strongly influenced by the status of the excision edges, that is by the radicalness of the surgical intervention. Irrespective of the latter, an adjuvant oncological treatment is to be prescribed, mainly systemic cytostatic therapy. Urachus adenocarcinoma is rarely encountered and very often diagnosed in late metastatic stages, when the only solution is at most paleative surgery.