Abstract

We present the clinical case of a 74-year-old woman with an urachal tumor diagnosed in 2004. The patient underwent a partial cystectomy of the dome with remotion of the urachal remnant and the umbilicus. She had been clinical well until 2011 when she had a kidney metastasis from the urachal tumor. Urachal tumors are very rare, comprising 0.17-0.34% of all bladder cancers. The most common sites of distant metastases are: lung, lymph nodes, bone, intestine, brain, liver, peritoneum, skin and spine. We describe an extremely rare case of a renal metastasis from an urachal cancer, seven years after the initial diagnosis. Usually, patients with localized disease have a good prognosis when treated with surgery. The prognosis gets worse for patients with metastases or local recurrence because a standard chemotherapy regimen does not exist.

Abstract

Due to considerable morbidity and mortality rates, radiation‐induced hemorrhagic cystitis is an important complication of pelvic irradiation. The available conservative treatment techniques show limited results. Hyperbaric oxygen has shown to be effective in the treatment of radiation‐induced lesions, including radiation cystitis. Our aim was to analyze the effectiveness and safety of hyperbaric oxygen therapy for refractory radiation‐induced hemorrhagic cystitis. Clinical records of 176 patients with refractory radiation‐induced hemorrhagic cystitis treated at our centre were retrospectively analyzed. The evolution of macroscopic hematuria was the main therapeutic outcome analyzed. 23, 9% of patients showed other radiation‐induced soft tissue lesions. After an average of 37 sessions of hyperbaric oxygen, 89, 8% of patients showed resolution of hematuria. Adverse events were reported in 1, 7% of patients. Hyperbaric oxygen was a safe and effective therapy for radiation‐induced hemorrhagic cystitis. Concomitant radiation‐induced soft tissue lesions were relatively frequent, which makes hyperbaric oxygen an excellent choice as first line treatment in those patients.