Urachal adenocarcinoma in an adolescent girl: A case report

The urachus is a fetal canal that connects the allantois to the bladder and typically obliterates by the 6th month of gestation. Failure of the urachus to obliterate can result in urachal anomalies, which, in rare cases, may undergo malignant transformation. We present a case of a 13-year-old female who experienced hematuria, dysuria, and abdominal pain persisting for over 4 months. A CT scan revealed a mass extending from the bladder wall, involving an adjacent bowel loop, and associated with intra-abdominal lymphadenopathy. Debulking surgery was performed, and a histopathological examination confirmed the diagnosis of urachal adenocarcinoma. Urachal anomalies are exceedingly rare, with malignancies arising from urachal remnants being even more uncommon. Most patients are diagnosed at advanced stages due to the late onset of symptoms, resulting in a five-year survival rate of approximately 50 %. Urachal adenocarcinoma can occur in children, potentially due to early oncogenesis of urachal cells. It should be considered a significant differential diagnosis in children presenting with recurrent lower abdominal pain and a urachal remnant to facilitate early detection and timely management.