Aggressive bone metastases in urachal carcinoma.

A 38-year-old female with urachal carcinoma showed extensive bone metastases 1 year after wide excision of the urachal tumor, including partial cystectomy. A combination of radiotherapy and systemic chemotherapy was offered. Local radiotherapy of 8 Gy as a single fraction or 10 Gy in two fractions was delivered to the painful regions of the skeletal system. Multiagent chemotherapy consisting of methotrexate, vinblastine, Adriamycin, and cisplatin was given for three cycles. The patient died 28 months after the initial presentation with progression of the disease to pelvis and skeletal sites. The problem of metastatic spread after initial resection should be considered in urachal carcinoma, and adjuvant chemoradiotherapy should improve the outcome in this rare neoplasm.