Brain metastasis from urachal carcinoma

Urachal carcinoma (UC) is a rare variant of bladder carcinoma. Only seven cases of brain metastasis from UC have been reported in the literature thus far.

A 77-year-old female was diagnosed with a brain tumor in her left cerebellum 2 years after she underwent surgery for a primary UC in the bladder. Surgery was performed via a midline suboccipital approach and the tumor was totally removed. The excised lesion was pathologically diagnosed as a metastasis and displayed typical pathological features of urachal adenocarcinoma with abundant mucin mixed with signet ring cells. A recurrence was observed at the site of tumor removal 6 months after surgery, and then, gamma knife radiotherapy was performed to the lesion.

According to the five previously reported similar cases and our case, tumor removal is the treatment of choice. Routine whole brain radiotherapy is not the best treatment choice; however, local radiotherapy including conventional local radiotherapy or gamma knife radiotherapy could be implemented instead.