Mystery of neck lump: an uncommon presentation of urachal cancer. Issue 8 (26th August 2019)

• Record Type: Journal Article
• Authors: Sahu, Kamal Kant; Pandey, Deepali; Mishra, Ajay Kumar; O'Shea, James; Chen, Yayan; McGregor, Bradley
• Is Part Of: BMJ case reports. Volume 12:Issue 8(2019)
• Publication Date: 2019-08-26
• Subjects: cancer intervention -- radiology (diagnostics) -- malignant disease and immunosuppression; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-230215
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : We present the case of a 55-year-old male patient who presented with palpable cervical lymphadenopathy. Excisional biopsy showed metastatic adenocarcinoma of unknown origin. Imaging showed a bladder mass following which he underwent transurethral resection of bladder tumour. Histopathological evaluation of mass confirmed a poorly differentiated adenocarcinoma with signet-ring cell features. Immunohistochemistry was suggestive of metastatic urachal cancer. He agreed for enrollment in a clinical trial, however soon after 1st cycle, he developed immune pneumonitis requiring high dose steroids. On follow-up, MRI brain was done for evaluation of headache which showed metastatic intracranial disease. He completed radiotherapy following which he was started on FOLFOX chemo regimen (folinic acid, 5-fluorouracil and oxaliplatin).