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Int J Clin Exp Pathol 2011;4(1):118-123

Case Report
Urachal adenocarcinoma metastatic to the ovaries resembling primary ovarian mucinous
carcinoma: a case report with the immunohistochemical study

Wonae Lee

Department of Pathology, College of Medicine Dankook University, Cheonan, Republic of Korea.

Received November 15, 2010; accepted December 23, 2010; Epub December 24, 2010; published January 1, 2011

Abstract: Urachal adencarcinoma is rare and its metastasis to the ovary is extremely rare. I report here on a case of urachal adenocarcinoma
that metastasized to bilateral ovaries in a 72-year-old female. She presented with vaginal spotting. Abdominal CT revealed a huge
multiloculated cystic mass in the recto-uterine pouch and a solid mass with dot calcification in the anterior pelvic cavity. The resected ovaries
were equal -sized at about 10cm at the greatest diameter. The sectioned surfaces were predominantly multicystic with a solid nodule.
Microscopically, both ovaries were mainly composed of cystic glands lined by mucin- containing epithelium with atypical nuclei. The solid
nodule consisted of irregularly infiltrating glands and single tumor cells. Two years later, the patient was admitted with hematuria. The kidney
CT revealed a solid mass with calcification in the bladder dome, which suggested urachal carcinoma. The partial cystectomy specimen
revealed an ill- defined ulcerative tumor. Histologically, the tumor corresponded to mucinous adenocarcinoma and centered at the bladder wall
with predominant invasion of the muscularis. The immunohistochemical profiles of the ovarian and urachal tumors were exactly the same. The
tumor cells were diffusely positive for CK20, CDX-2, MUC2 and MUC5AC, focally positive for 34βE12 and negative for CK7. (IJCEP1011003).

Keywords: Urachus, ovarian neoplasm, metastasis, mucinous, adenocarcinoma

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Address all correspondence to:
Wonae Lee, MD, PhD
Department of Pathology
College of Medicine, Dankook University
San 29 Anseo-Dong, Donnam-gu, Cheonan-si,
Chungcheong Nam Do, 330-715
Republic of Korea.
Tel. 82+041-550-3895, Fax. 82+041-561-9127