Korean J Urol.  2010 Jul;51(7):498-500.

Alpha-Methylacyl-Coenzyme A Racemase-Expressing Urachal Adenocarcinoma of the Abdominal Wall

• Ha YS
• Kim YW
• Min BD
• Lee OJ
• Kim YJ
• Yun SJ
• Lee SC
• Kim WJ

Abstract

Urachal adenocarcinomas are very rare and about one third of these neoplasms arise in urachal remnants. To demonstrate the origin of the urachal adenocarcinoma is not easy, but it is very important for managing patient care. We report on a 35-year-old man who complained of a palpable mass in the periumbilical area. The mass was incidentally identified 10 days earlier. Computed tomography revealed a well-defined enhancing mass with internal calcification and septation abutting on the dome of the urinary bladder. The clinical diagnosis was urachal cancer, which seemed to invade the urinary bladder. Thus, we performed mass excision and partial resection of the bladder. Histopathologically, the mass was diagnosed as mucinous cystadenocarcinoma originating from urachal remnants that showed an unusual expression of alpha-methylacyl-coenzyme A racemase (AMACR). To our knowledge, this report is the first case of AMACR-expressing urachal adenocarcinoma arising in the abdominal wall.

Keyword

Alpha-methylacyl-CoA racemase; Biological markers; Cystadenocarcinoma, mucinous; Urachus

MeSH Terms

Abdominal Wall*
Adenocarcinoma*
Adult
Biomarkers
Cystadenocarcinoma, Mucinous
Diagnosis
Humans
Patient Care
Urachus
Urinary Bladder

Figure

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  FIG. 1 Computed tomography through the lower abdomen showing a midline-lying, well circumscribed multilocular calcified cystic mass (arrow).

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  FIG. 2 Photomicrograph of the wall of the multilocular cystic mass shows mucin lakes by immunohistochemistry (H&E, ×100).

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  FIG. 3 The lining tumor cells are stratified columnar epithelium that shows oval to round nuclei and abundant cytoplasm by immunohistochemistry (H&E, ×400).

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  FIG. 4 The tumor cells express alpha-methylacyl-coenzyme A racemase by immunohistochemistry (H&E, ×400).

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