Synchronous urothelial carcinoma of the bladder and urachal adenoma with subsequent malignant transformation.

Malignant transformation of urachal adenoma is exceedingly rare, with intestinal metaplasia as the most common contributing mechanism. It is recommended that a urachal adenoma be regarded as a pre-malignant condition and be subject to endoscopic surveillance. A local en block excision of the tumor mass with urachalectomy and umbilectomy results in possible long-term survival. The median survival after platinum-based chemotherapy is limited for patients with extravesical disease. Here we report a case of synchronous urothelial carcinoma of the bladder and urachal adenoma that transformed into adenocarcinoma.