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Case Reports
. 2025 Feb 8;17(2):e78741.
doi: 10.7759/cureus.78741. eCollection 2025 Feb.

Robotic Excision of an Incidental Urachal Mucinous Cystadenocarcinoma in a Patient With Concomitant Endometrial Carcinoma

William A Langbo  1 , Jamie Yoon  1 , Han Hee D Kim  1 , Katherine M Sinchek  1 , Alexander K Chow  1
Affiliations
Case Reports

Robotic Excision of an Incidental Urachal Mucinous Cystadenocarcinoma in a Patient With Concomitant Endometrial Carcinoma

William A Langbo et al. Cureus. .

Abstract

Urachal cystadenocarcinoma (UC) is a rare but highly aggressive subtype of bladder cancer. While most localized cases of UC are asymptomatic, occasionally, patients present with nonspecific lower urinary tract symptoms. Unfortunately, most cases are not detected until advanced disease is present. The presence of local nodal or distant metastasis is particularly important for prognosis, drastically reducing five-year overall survival rates. The gold standard for localized UC is wide surgical excision, with no established role of chemotherapy. On the contrary, endometrial carcinoma (EC) is the most common gynecologic malignancy. As such, staging, prognosis, and treatment guidelines of endometrial carcinoma are well-established. The gold standard treatment for localized endometrial carcinoma includes total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) and lymph node dissection (LND). Concurrent cases of urachal cystadenocarcinoma and endometrial carcinoma are exceedingly rare. To the authors' knowledge, there have been no known reports of these co-occurring malignancies thus far in the literature. We present the case of a 66-year-old patient with nonspecific lower urinary symptoms and incidentally discovered UC in the setting of concurrent endometrial carcinoma. The patient underwent robotic excision of the urachal cystadenocarcinoma and TAH-BSO, followed by adjuvant chemotherapy and vaginal brachytherapy. Surveillance imaging at 16 weeks after surgery showed no evidence of disease recurrence.

Keywords: adenocarcinoma; bladder cancer; endometrial carcinoma; robotics; urachal cancer; urachus.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Sagittal MRI depicting the urachal mucinous cystadenocarcinoma in relation to the urinary bladder.
MRI: magnetic resonance imaging
Figure 2
Figure 2. Sagittal CT of the abdomen and pelvis re-demonstrating the urachal mucinous cystadenocarcinoma in relation to the urinary bladder.
CT: computed tomography
Figure 3
Figure 3. Postoperative sagittal CT of the abdomen and pelvis demonstrating no evidence of disease recurrence.
CT: computed tomography
See this image and copyright information in PMC

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