Urachal adenocarcinoma presenting as pseudomyxoma peritonei: an unusual bladder tumour

A man in his 50s presented to the emergency department with a complaint of progressively increasing swelling in the lower abdomen. Investigations revealed a large pelvic mass for which a fine needle aspiration cytology was done, which was suggestive of adenocarcinoma. He was then referred to a urologist in view of suspected urachal adenocarcinoma. Following preoperative evaluation, he was taken up for tumour excision with partial cystectomy and extended pelvic lymph node dissection. Intraoperatively, there was a growth involving the dome of the bladder with mucinous ascites and multiple omental and peritoneal nodules. A gastrointestinal surgery consultation was sought, and eventually, he underwent tumour excision, omphalectomy, partial cystectomy, omentectomy, appendectomy, peritonectomy and hyperthermic intraperitoneal chemotherapy with mitomycin C. He recovered well in the postoperative period. The follow-up of 18 months showed no evidence of disease.