Open AccessMystery of neck lump: an uncommon presentation of urachal cancer
Author(s) -
Kamal Kant Sahu,
Deepali Pandey,
Ajay Kumar Mishra,
James O’shea,
Yayan Chen,
Bradley A. McGregor
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-230215
Subject(s) - medicine , cervical lymphadenopathy , folinic acid , adenocarcinoma , radiation therapy , oxaliplatin , cancer , biopsy , radiology , surgery , disease , fluorouracil , colorectal cancer
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).