A Critical Study of Late Presenting Urachal Remnant Tumour: Rare Adenocarcinoma Originated from Developmental Defect |Chapter 10 | Trends in Pharmaceutical Research and Development Vol. 1

Occupying only 0.01% of all adult cancer patients, the rare entity urachal adenocarcinoma constitutes 22-35% of adenocarcinomas originating from urinary bladder. Though with the gradual descend of the bladder in the course of development urachus should turn into median umbilical ligament, exceptional persistence of it can give rise to urachal cyst or urachal adenocarcinoma in adulthood. With only 43% of survival rate for 5 years and mean survival between 12 and 24 months urachal carcinoma is a devastating disease. Diagnosis of it is based on the MD Anderson Cancer Centre (MDACC) criteria. Computed Tomography (CT) Scan and/or Magnetic Resonance Imaging (MRI) Scan of abdomen and pelvis are the major imaging modalities to proceed towards diagnosis and staging. Not only histopathological examination but also immune-histochemical expression of both CK7 and CK20 suffice to clinch the diagnosis. Though surgical intervention forms the mainstay of treatment, several regimens of chemotherapy have also been tried to fight against unresectable, residual, extensive urachal carcinomas. This case took place in a 52 years old male patient who was presented with a gradually enhancing infra-umbilical swelling with slow growing urinary symptoms. By dint of Ultrasonography (USG) and Contrast Enhanced CT (CECT) scan of whole abdomen the tumour was detected involving the bladder wall and the anterior abdominal wall. Cystoscopy was followed by upfront cytoreductive surgery. Histopathological examination revealed the diagnosis of an adenocarcinoma which was further confirmed to be an urachal remnant carcinoma with the help of immunohistochemistry. Postoperative CT scan showed residual disease involving bladder wall and was treated with an adjuvant platin based chemotherapy regimen.

Author (s) Details

Ipsita Dey
Department of Pathology, R. G. Kar Medical College and Hospital, Kolkata, India.

Tushar Kanti Das
Department of Pathology, R. G. Kar Medical College and Hospital, Kolkata, India.

Chhaya Roy
Department of Radiation Oncology, R. G. Kar Medical College and Hospital, Kolkata, India.

View Book: – http://bp.bookpi.org/index.php/bpi/catalog/book/156

Prevalence of Clinically Concealed Prostatic Diseases at Post Mortem: A Teaching Hospital Experience in South-South, Nigeria | Chapter 03 | Innovations in Medicine and Medical Research Vol. 1

Background: Most post-mortem studies on prostate gland are limited to malignant prostatic tumours. The possibilities of finding other histological types of prostatic diseases were worth exploring bearing in mind that Nodular hyperplasia and cancer are of epidemiological importance.

Aim: This study aims to determine the pattern of prostatic diseases at post-mortem among individuals not previously diagnosed with prostate disease and who died from other causes.

Materials and Methods: Prostate glands at post-mortem were obtained from individuals who died from non-prostate related causes, weighed, fixed in 10% neutral buffered formalin, processed and histologically analysed. Biodata and clinical diagnoses were obtained using clinical case notes and post-mortem register.

Results: The population under study were 86 adult males whose ages ranged from 30 to 85 years with a mean age of 52.71 ± 13.10 years. Ninety-three percent (93% / 80 cases) of the study population were afflicted with prostatic diseases at post-mortem. The most common lesion was nodular hyperplasia. Latent or occult adenocarcinoma followed this, prostatic intraepithelial neoplasia and Schistosomiasis in decreasing order of frequency. The frequency of occult adenocarcinoma, prostatic intraepithelial neoplasia (PIN) and nodular hyperplasia increased significantly with age (P ≤ 0.05). The peak age for the development of occult adenocarcinoma, PIN and nodular hyperplasia was in the 6th, 8th and 6th decades respectively.

Conclusion: Clinically concealed prostatic diseases are common findings at post-mortem. There is a significant increase (P ≤ 0.05) in the frequency of covert prostatic diseases (nodular hyperplasia, PIN and adenocarcinoma) with advancing age. Convert prostatic diseases especially nodular hyperplasia and prostatic carcinoma have the potentials of contributing significantly to the burden of health care and the cost of receiving treatment if the life expectancy improves in our environment in particular and Nigeria in general.

Author(s) Details

E. Imasogie Dele
Department of Morbid Anatomy, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.

T. Azeke Akhator
Department of Anatomic Pathology, Irrua Specialist Teaching Hospital, Nigeria.

View Volume: http://bp.bookpi.org/index.php/bpi/catalog/book/139