Carcinoma of the urachus.

Two cases of carcinoma of the urachus are reported, 1 involving the dome of the bladder and 1 occurring beneath the peritoneum of the anterior abdominal wall below the umbilicus at the apex of an elongated bladder. Both patients died shortly after diagnosis, a fact which emphasizes the poor prognosis of this group of patients. The poor prognosis and need for more than local resection of the tumour may not be widely appreciated. Tumours arising above the bladder have a different mode of presentation from those arising within the bladder wall. Bladder wall tumours are most frequently mucus-secreting adenocarcinomas; tumours arising above the bladder may be more variable in their histological type, and include squamous and undifferentiated cancer. A simple classification into vesicle and supra-vesical tumours is proposed, to replace an early classification into 7 groups.