According to the American Urological Association, the diagnostic criteria are the following: # The location of the tumor is mostly at the bladder dome. # No findings of cystitis glandularis on the bladder surface. These findings can be precursor lesions of a primary bladder adenocarcinoma. # No history of a different primary adenocarcinoma with the same morphology. Tissue for histological analysis is usually obtained via a transurethral resection of bladder tumor (TURBT). Histopathological Diagnosis A case of urachal adenocarcinoma demonstrating immunohistochemical CDX2-positivity with typical nuclear staining. 200x magnification.|left According to the current version (4th ed.) of the WHO classification of Tumours of the Urinary System, the diagnosis of an urachal adenocarcinoma usually needs a location of the tumor in the bladder dome and/or anterior wall, epicenter of the tumor in the bladder wall, absence of widespread cystitis cystica and/or cystitis glandularis beyond the dome or anterior wall, and absence of another similar structured tumor as a primary tumor elsewhere in the body. A urachal remnant in association with the tumor can help with the diagnosis. In addition, other diagnostic systems also for urachal carcinomas that are not adenocarcinomas have been proposed. Immunohistochemical stains are usually less helpful in the histopathological differential diagnosis of urachal adenocarcinomas. Imaging CT and MRI scans are useful to evaluate local invasion and metastasis to lymph nodes and other parts of the body. Besides, in 32 to 46% of the cases, they show calcifications which is very suggestive of the disease.
Urachal cancer
Rectovestibular fistula
Urachal cyst
Urachal fistula
Vulvar vestibulitis
Cimino fistula
Haemolacria
Pilonidal disease