title: Surgical treatment of recurrent urachal carcinoma with liver metastasis: a case report and literature review.
abstract: BACKGROUND
  Urachal carcinoma is a rare malignancy with poor prognosis due to late presentation of the disease and its aggressiveness. Surgery remains the mainstay of therapy even in cases of disease recurrence. To the best of our knowledge, this is the first report of salvage surgery in the case of urachal carcinoma with liver metastasis.
  
  
  METHODS
  The patient was a young woman who suffered from locally advanced urachal carcinoma treated with en-bloc cystectomy, hysterectomy with bilateral adnexectomy, partial resection of the sigmoid colon, and partial resection of the rectus abdominis muscle with the fascia, skin, and umbilicus. Adjuvant chemotherapy with paclitaxel and carboplatin was applied. Two years after the treatment, she was diagnosed with a single liver metastasis and a local pelvic recurrence. In a two-step operation, the patient underwent right hemihepatectomy as well as resection of pelvic recurrence site and adjuvant chemotherapy with gemcitabine. Due to the disease progression, a complete resection of the lesions was not achieved and the response to chemotherapy was poor. The patient died of the disease after a year.
  
  
  CONCLUSIONS
  Surgery is the first line of treatment for urachal carcinoma and should be always considered as an option in cases of disease recurrence. Radical initial surgical management, close patient surveillance, and prompt treatment of disease relapse may all contribute to prolonging patient's survival.
authors.affiliation: Department of Liver and General Surgery, Nicolaus Copernicus University, Curie-Sklodowskiej 9, Bydgoszcz, 85-094, Poland. paschkelukasz@gmail.com.|Department of Urology, Nicolaus Copernicus University, Bydgoszcz, Poland. paschkelukasz@gmail.com.
authors.forename: Lukasz
authors.identifier: http://orcid.org/0000-0002-9481-7876
authors.initials: L
authors.lastname: Paschke
authors.affiliation: Department of Liver and General Surgery, Nicolaus Copernicus University, Curie-Sklodowskiej 9, Bydgoszcz, 85-094, Poland.
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Juszczak
authors.affiliation: Department of Liver and General Surgery, Nicolaus Copernicus University, Curie-Sklodowskiej 9, Bydgoszcz, 85-094, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Slupski
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D015653:Cystectomy; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007044:Hysterectomy; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000627:therapeutic use; D010386:Pelvic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D016879:Salvage Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D003841:Deoxycytidine; D016190:Carboplatin; D017239:Paclitaxel; D000093542:Gemcitabine
keywords: Adjuvant chemotherapy; Salvage surgery; Urachal carcinoma