American Urological Association - Urachal Adenocarcinoma
- Diagnostic criteria:
- Tumor located at bladder dome (mostly) or anterior wall.
- Tumor epicenter in bladder wall.
- Absence of florid cystitis glandularis in bladder surface (exclude precursor lesions of primary bladder adenocarcinoma)
- Absence of know primary adenocarcinoma of same morphology elsewhere.
- More often the tumor has the appearance of a mucinous ("colloid") carcinoma (tumor cells floating in a sea of mucin) (image A), (image B), (image C), & (image D).
- May also have enteric morphology (looks like colorectal adenocarcinoma).
- Other morphologies include signet ring cell, which can diffusely spread into the bladder, and adenocarcinoma, not otherwise classifiable, or a mixed of these different patterns.
- Similar immunohistochemical staining (CDX2+, CK7+ and β-catenin-) with urachal adenocarcinoma.
- Treated by en bloc resection of bladder, urachal remnant, and umbilicus.
- Staging is different from bladder urothelial carcinoma.
- Poor survival, reported 5-year survival at 25-61%.