Urachal cancer: a rare and aggressive malignancy - clinical case report and therapeutic management

Urachal carcinoma is a rare and aggressive tumor arising from the embryonic remnant connecting the bladder dome to the umbilicus. It accounts for less than 1% of bladder cancers and typically affects patients aged 52 to 59 years. Surgical resection with negative margins is the mainstay of treatment for localized disease, often involving urachal excision, partial or radical cystectomy, and lymphadenectomy. Chemotherapy has limited established efficacy but may be used in advanced cases. Five-year overall survival is around 50%, with poorer outcomes in metastatic disease. This report describes a 61-year-old patient presenting with hematuria, diagnosed with urachal adenocarcinoma through cystoscopy and biopsy. The patient underwent radical surgery with complete tumor removal followed by regular PET scan follow-up. This case highlights the importance of early detection and definitive surgical management of this rare malignancy.