Metastatic Urachal Carcinoma Treated With Several Different Combined Regimens: A Case Report

Abstract

Urachal carcinoma is a rare bladder malignance. This study presents a case of an elderly patient with urachal carcinoma who was found to have pulmonary metastases 1 year after 5 recurrent resections. The patient was treated with up to 7 different chemotherapy regimens, including a VEGF monoclonal antibody and anti-PD-1 antibody. This is the first report of PD-1 antibody being used in patients with urachus, although the disease progressed after only four cycles of the application. The patient's disease was controlled by the FOLFIRI combined with the VEGF monoclonal antibody regimen. The most prominent issues at present are the difficulty of obtaining drugs for rare cancers and the lack of late-stage clinical trials to guide therapeutic decisions.

Keywords: combination chemotherapy; immunity therapy; serum marker; targeted therapy; urachal carcinoma.

Figure 1

(A, B) Hematoxylin and eosin staining; magnification ×100 and ×200, Duct cells are observed in the loose stroma. (C, D) Hematoxylin and eosin staining; magnification ×100 and ×200, Urachal mucinous adenocarcinoma, groups of tumour cells surrounded by extracellular mucin.

Figure 2

Timeline of the Serum marker.

Figure 3

(A–C) Chest CT before administration of Irinotecan. (D–F) Chest CT after 3 cycles Irinotecan and bevacizumab therapy. (G–I) After 6 cycles Irinotecan and bevacizumab therapy. The pulmonary metastatic lesions were reduced by 50%.