{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:47:03Z","timestamp":1773967623856,"version":"3.50.1"},"reference-count":88,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Urachal carcinoma (UrC) is an uncommon malignant neoplasm arising from urachal remnants and represents only 0.01%\u20130.7% of bladder cancers. Adenocarcinoma\u2014usually of the intestinal type\u2014accounts for over 80% of cases, whereas neuroendocrine carcinoma (NEC) is exceedingly rare. Fewer than ten cases of urachal NEC have been documented in the English-language literature, most diagnosed at advanced stages with poor outcomes. We report an additional case and review published data to enhance clinical recognition and management of this ultra-rare tumor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 43-year-old woman presented to Shandong Provincial Hospital, Shandong First Medical University, after a urachal midline mass was incidentally detected on routine health examination. Preoperative tests showed a CEA level of 7.28 ng\/mL. CTU revealed a 3.9 \u00d7 2.7 \u00d7 2.4 cm cystic\u2013solid lesion at the anterior bladder wall, suspicious for urachal malignancy. Cystoscopic biopsy confirmed small-cell NEC. The patient underwent laparoscopic urachal resection with umbilicus preservation, extended partial cystectomy, and bilateral pelvic lymphadenectomy. Postoperative pathology showed a mixed urachal carcinoma composed of ~80% small-cell NEC and ~20% adenocarcinoma, forming a 4.5 \u00d7 3 \u00d7 1.5 cm cystic\u2013solid mass. Margins and lymph nodes were negative. Immunohistochemical analysis showed a high Ki-67 labeling index (80%) and positive staining for synaptophysin (Syn), chromogranin A (CgA), insulinoma-associated protein 1 (INSM1), cytokeratin 20 (CK20), and mutant-pattern p53. Retinoblastoma protein (RB) and GATA-3 were negative. The patient received four cycles of adjuvant etoposide\u2013cisplatin (EP) chemotherapy. Surveillance with tumor markers and whole-abdominal CT every three months showed no evidence of recurrence at the 8-month follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Urachal NEC with mixed small-cell and adenocarcinoma components is an exceptionally rare and highly aggressive malignancy lacking standardized diagnostic or therapeutic guidelines. Complete surgical excision with negative margins remains the mainstay of treatment, while adjuvant regimens are typically adapted from small-cell carcinoma protocols of the lung or urinary tract. We report a case managed with umbilicus-sparing urachectomy and extended partial cystectomy followed by EP chemotherapy, together with a review of nine previously published cases. These findings provide literature-based evidence to guide individualized management and inform future multidisciplinary research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1676835","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T05:16:10Z","timestamp":1763010970000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A case-based review of urachal carcinoma with mixed small cell neuroendocrine and adenocarcinoma components, with one new case report and analysis of nine published cases"],"prefix":"10.3389","volume":"16","author":[{"given":"Junhao","family":"Chu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiwei","family":"Zhai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qimei","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhihui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanhua","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huisheng","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunxiao","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muwen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.5164","article-title":"Urachal carcinoma: A novel staging system utilizing the National Cancer Database","volume":"12","author":"Limonnik","year":"2023","journal-title":"Cancer Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.03.022","article-title":"Urachal carcinoma: contemporary surgical outcomes","volume":"178","author":"Herr","year":"2007","journal-title":"J Urol"},{"key":"B3","article-title":"Cancer colloide de la lombille et de paroi abdominale ant\u00e9rieure ayant envahi la vessie","volume":"6","author":"Hue","year":"1863","journal-title":"Union M\u00e9dicale la Seine-Inf\u00e9rieure (Rouen)"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2019.1646592","article-title":"Radical cystoprostatectomy to treat urachal carcinoma","volume":"32","author":"Ebrahim","year":"2019","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31823fe49c","article-title":"Urachal carcinomas of the nonglandular type: salient features and considerations in pathologic diagnosis","volume":"36","author":"Paner","year":"2012","journal-title":"Am J Surg Pathol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"102175","DOI":"10.1016\/j.clgc.2024.102175","article-title":"Urachal carcinoma: insights from a national database","volume":"22","author":"Orsini","year":"2024","journal-title":"Clin Genitourin Cancer"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3892\/mco.2016.1082","article-title":"Urachal carcinoma: Report of two cases and review of the literature","volume":"6","author":"Quan","year":"2017","journal-title":"Mol Clin Oncol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e70604","DOI":"10.7759\/cureus.70604","article-title":"Primary urachal squamous cell carcinoma: A case report","volume":"16","author":"Rajyakodi","year":"2024","journal-title":"Cureus"},{"key":"B9","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1186\/s13000-024-01490-5","article-title":"Urachal mixed adenocarcinoma and small cell neuroendocrine carcinoma with widespread metastasis and resistance to chemotherapy: a case report","volume":"19","author":"Obiedat","year":"2024","journal-title":"Diagn Pathol"},{"key":"B10","article-title":"Adenocarcinoma with a neuroendocrine component arising in the urachus","volume":"34","author":"Hom","year":"1990","journal-title":"A Case Rep Acta Cytol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/0090-4295(85)90112-8","article-title":"Urachal carcinoma","volume":"26","author":"Johnson","year":"1985","journal-title":"Urology"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1159\/000475079","article-title":"Mixed adenocarcinoma and neuroendocrine carcinoma arising in the urachus. A case report and review of the literature","volume":"28","author":"Munichor","year":"1995","journal-title":"Eur Urol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2017.08.003","article-title":"High-grade neuroendocrine carcinoma of the urachus-report of 3 cases","volume":"67","author":"Wang","year":"2017","journal-title":"Hum Pathol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1199395","article-title":"Progress and prospects of targeted therapy and immunotherapy for urachal carcinoma","volume":"14","author":"Zheng","year":"2023","journal-title":"Front Pharmacol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1892","DOI":"10.3390\/diagnostics12081892","article-title":"An unusual possibility of hematuria; case report and literature review","volume":"12","author":"Tiutiuca","year":"2022","journal-title":"Diagnostics (Basel) 12"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s13193-022-01679-4","article-title":"Peritoneal surface Malignancies originating from urachal carcinoma: case reports and review of the literature","volume":"14","author":"Van Breusegem","year":"2023","journal-title":"Indian J Surg Oncol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"100711","DOI":"10.1016\/j.currproblcancer.2021.100711","article-title":"Urachal carcinoma: A case of a rare neoplasm","volume":"45","author":"Moreira","year":"2021","journal-title":"Curr Probl Cancer"},{"key":"B18","article-title":"Cancer collo\u00efde de la lombille et de la paroi abdominale ant\u00e9rieure ayant envahi la vessie","volume":"8","author":"Hue","year":"1863","journal-title":"Bull la Soci\u00e9t\u00e9 Anatomique Paris"},{"key":"B19","doi-asserted-by":"crossref","DOI":"10.1097\/00000441-191609000-00017","volume-title":"Embryology, anatomy, and diseases of the umbilicus together with diseases of the urachus","author":"Cullen","year":"1916"},{"key":"B20","article-title":"The urachus: its anatomy, histology and development","volume":"64","author":"Begg","year":"1930","journal-title":"J Anat"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.3059","article-title":"Urachal carcinoma: Impact of recurrence pattern and lymphadenectomy on long-term outcomes","volume":"9","author":"Duan","year":"2020","journal-title":"Cancer Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31819aa4ae","article-title":"Urachal carcinoma: a clinicopathologic analysis of 24 cases with outcome correlation","volume":"33","author":"G. A","year":"2009","journal-title":"Am J Surg Pathol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22060","article-title":"Urachal carcinoma: clinicopathologic features and long-term outcomes of an aggressive Malignancy","volume":"107","author":"Ashley","year":"2006","journal-title":"Cancer"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1586\/14737140.6.12.1715","article-title":"Urachal carcinoma: surgical and chemotherapeutic options","volume":"6","author":"S.-R.","year":"2006","journal-title":"Expert Rev Anticancer Ther"},{"key":"B25","article-title":"Urachal carcinomas of the bladder: a clinicopathologic study of 24 cases","volume":"19","author":"P. GP","year":"2006","journal-title":"Mod Pathol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.euros.2022.02.009","article-title":"Current management of urachal carcinoma: an evidence-based guide for clinical practice","volume":"39","author":"Loizzo","year":"2022","journal-title":"Eur Urol Open Sci"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23070","article-title":"Predictors of survival from urachal cancer","volume":"110","author":"Molina","year":"2007","journal-title":"Cancer"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqac039","article-title":"Distinct gene mutations are associated with clinicopathologic features in urachal carcinoma","volume":"158","author":"Zaleski","year":"2022","journal-title":"Am J Clin Pathol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/S0022-5347(17)50167-6","article-title":"Malignant urachal lesions","volume":"131","author":"Sheldon","year":"1984","journal-title":"J Urol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31819aa4ae","article-title":"Urachal carcinoma: A clinicopathologic analysis of 24 cases with outcome correlation","volume":"33","author":"Gopalan","year":"2009","journal-title":"Am J Surg Pathol"},{"key":"B31","article-title":"A practical staging system for urachal carcinoma based on pathologic stage and prognosis","volume":"176","author":"Pinthus","year":"2006","journal-title":"J Urol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2016.04.012","article-title":"Clinical, prognostic, and therapeutic aspects of urachal carcinoma\u2014A comprehensive review with meta-analysis of 1,010 cases","volume":"34","author":"Szarvas","year":"2016","journal-title":"Urologic Oncol Semin Original Investigations"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2019.01274","article-title":"Imaging features of urachal cancer: A case report","volume":"9","author":"Chen","year":"2019","journal-title":"Front Oncol 9"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.683190","article-title":"The prognosis and oncological predictor of urachal carcinoma of the bladder: A large scale multicenter cohort study analyzed 203 patients with long term follow-up","volume":"11","author":"Yu","year":"2021","journal-title":"Front Oncol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2020.00437","article-title":"Evaluation of uroVysion for urachal carcinoma detection","volume":"7","author":"Hu","year":"2020","journal-title":"Front Med 7"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1110003","article-title":"Urachal carcinoma: a large retrospective multicentric study from the French Genito-Urinary Tumor Group","volume":"13","author":"Guerin","year":"2023","journal-title":"Front Oncol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"154379","DOI":"10.1016\/j.prp.2023.154379","article-title":"Urachal carcinoma: The journey so far and the road ahead","volume":"243","author":"Kumar","year":"2023","journal-title":"Pathol Res Pract"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2014.2502","article-title":"Investigating urachal carcinoma for more than 15 years","volume":"8","author":"Chen","year":"2014","journal-title":"Oncol Lett"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1007\/s00292-018-0516-9","article-title":"Urachal cancer\u2014current concepts of a rare cancer","volume":"40","author":"Reis","year":"2019","journal-title":"Der Pathologe"},{"key":"B40","doi-asserted-by":"publisher","first-page":"345 e9","DOI":"10.1016\/j.urolonc.2022.02.017","article-title":"Value of MRI in evaluating urachal carcinoma: A single center retrospective study","volume":"40","author":"Das","year":"2022","journal-title":"Urol Oncol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1159\/000518028","article-title":"Clinical, pathological, and prognostic analysis of urachal carcinoma","volume":"106","author":"Shao","year":"2022","journal-title":"Urol Int"},{"key":"B42","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1186\/1477-7819-11-170","article-title":"Surgical and chemotherapeutic experience regarding a urachal carcinoma with repeated relapse: case report and literature review","volume":"11","author":"Zong","year":"2013","journal-title":"World J Surg Oncol"},{"key":"B43","doi-asserted-by":"publisher","first-page":"e19705","DOI":"10.7759\/cureus.19705","article-title":"Small bowel obstruction due to metastatic urachal adenocarcinoma: A rare presentation","volume":"13","author":"Sharma","year":"2021","journal-title":"Cureus"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000054646.49381.01","article-title":"Multimodality management of urachal carcinoma: the M","volume":"169","author":"Siefker-Radtke","year":"2003","journal-title":"D. Anderson Cancer Center Experience. J Urol"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2009.08451.x","article-title":"Neuroendocrine tumours of the urinary system and male genital organs: clinical significance","volume":"103","author":"Mazzucchelli","year":"2009","journal-title":"BJU Int"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19810215)47:4<724::AID-CNCR2820470417>3.0.CO;2-2","article-title":"Neurosecretory granules in small cell invasive carcinoma of the urinary bladder","volume":"47","author":"Cramer","year":"1981","journal-title":"Cancer"},{"key":"B47","article-title":"III The notable topics of the 5th edition of WHO classification for the thoracic tumours(2021)","volume":"49","author":"Minami","year":"2022","journal-title":"Gan to kagaku ryoho. Cancer chemotherapy"},{"key":"B48","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s12105-013-0513-5","article-title":"Primary combined neuroendocrine and squamous cell carcinoma of the maxillary sinus: report of a case with immunohistochemical and molecular characterization","volume":"9","author":"Franchi","year":"2013","journal-title":"Head Neck Pathol"},{"key":"B49","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1111\/j.1365-2559.2004.01980.x","article-title":"Small cell carcinoma of the bladder: a contemporary clinicopathological study of 51 cases","volume":"46","author":"Abrahams","year":"2010","journal-title":"Histopathology"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20456","article-title":"Small cell carcinoma of the urinary bladder: A clinicopathologic analysis of 64 patients","volume":"101","author":"Cheng","year":"2004","journal-title":"Cancer"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1111\/his.14714","article-title":"Diagnostic criteria and evolving molecular characterisation of pulmonary neuroendocrine carcinomas","volume":"81","author":"Williams","year":"2022","journal-title":"Histopathology"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0000000000004695","article-title":"Metastatic small cell neuroendocrine carcinoma of endometrium","volume":"48","author":"Gupta","year":"2023","journal-title":"Clin Nucl Med"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.916506","article-title":"Small cell (Neuroendocrine) carcinoma of the cervix: an analysis for 19 cases and literature review","volume":"12","author":"Lu","year":"2022","journal-title":"Front Cell Infection Microbiol 12"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2016.1155982","article-title":"Small cell carcinoma of the urinary bladder: changing trends in the current literature","volume":"32","author":"Erdem","year":"2016","journal-title":"Curr Med Res Opin"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.76936","article-title":"Integrated pathological analysis to develop a Gal-9 based immune survival stratification to predict the outcome of lung large cell neuroendocrine carcinoma and its usefulness in immunotherapy","volume":"18","author":"Che","year":"2022","journal-title":"Int J Biol Sci"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-022-01090-y","article-title":"Genetic and immunohistochemical profiling of small cell and large cell neuroendocrine carcinomas of the breast","volume":"35","author":"Bean","year":"2022","journal-title":"Mod Pathol"},{"key":"B57","doi-asserted-by":"publisher","first-page":"5138","DOI":"10.3390\/jcm12155138","article-title":"A comprehensive review on neuroendocrine neoplasms: presentation, pathophysiology and management","volume":"12","author":"Sultana","year":"2023","journal-title":"J Clin Med"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-024-03904-7","article-title":"Insulinoma-associated protein-1 (INSM-1) is a useful diagnostic marker for the evaluation of primary thymic neuroendocrine neoplasms: an immunohistochemical study of 27 cases","volume":"486","author":"Suster","year":"2025","journal-title":"Virchows Archiv"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.14213","article-title":"Urinary tract large cell neuroendocrine carcinoma: diagnostic, prognostic and therapeutic issues","volume":"40","author":"Sanguedolce","year":"2020","journal-title":"Anticancer Res"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2019-0250-OA","article-title":"Diagnostic value of insulinoma-associated protein 1 (INSM1) and comparison with established neuroendocrine markers in pulmonary cancers A comprehensive study and review of the literature","volume":"144","author":"Staaf","year":"2020","journal-title":"Arch Pathol Lab Med"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1080\/00016480410016540","article-title":"Immunohistochemical studies in support of a diagnosis of small cell neuroendocrine carcinoma of the larynx","volume":"124","author":"Rinaldo","year":"2004","journal-title":"Acta Otolaryngol"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1007\/s12022-023-09755-3","article-title":"Diagnostic, prognostic, and predictive role of Ki-67 proliferative index in neuroendocrine and endocrine neoplasms: past, present, and future","volume":"32","author":"La Rosa","year":"2021","journal-title":"Endocrine Pathol"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1097\/PAT.0000000000000301","article-title":"High grade neuroendocrine carcinoma of the urinary bladder treated by radical cystectomy: a series of small cell, mixed neuroendocrine and large cell neuroendocrine carcinoma","volume":"47","author":"Gupta","year":"2015","journal-title":"Pathology"},{"key":"B64","article-title":"Large cell neuroendocrine carcinoma of the urinary bladder","volume":"64","author":"Mart\u00edn","year":"2011","journal-title":"Bibliographic review. Archivos Espaoles Urolog\u00eda"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-024-04006-0","article-title":"Diagnostic relevance of p53 and Rb status in neuroendocrine tumors G3 from different organs: an immunohistochemical study of 465 high-grade neuroendocrine neoplasms","volume":"486","author":"Kanaan","year":"2024","journal-title":"Virchows Archiv"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2015.11.067","article-title":"Urachal carcinoma of the bladder: impact of clinical and immunohistochemical parameters on prognosis","volume":"195","author":"Niedworok","year":"2016","journal-title":"J Urol"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.3109\/03602539409029793","article-title":"Mutational spectrum of the p53 tumor suppressor gene: clues to cancer etiology and molecular pathogenesis","volume":"26","author":"Lehman","year":"1994","journal-title":"Drug Metab Rev"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-018-2467-1","article-title":"Urachal carcinoma: from gross specimen to morphologic, immunohistochemical, and molecular analysis","volume":"474","author":"Riva","year":"2019","journal-title":"Virchows Archiv"},{"key":"B69","doi-asserted-by":"publisher","first-page":"e927913","DOI":"10.12659\/MSM.927913","article-title":"Urachal carcinoma: are lymphadenectomy and umbilectomy necessary","volume":"26","author":"Jia","year":"2020","journal-title":"Med Sci Monit"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2024.01.045","article-title":"A case of primary small-cell neuroendocrine carcinoma of the bladder","volume":"47","author":"Wang","year":"2024","journal-title":"Asian J Surg"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.662589","article-title":"Metastatic urachal carcinoma treated with several different combined regimens: A case report","volume":"11","author":"Zheng","year":"2021","journal-title":"Front Oncol"},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1034245","article-title":"Primary urachal signet ring cell carcinoma: A case report","volume":"12","author":"Wang","year":"2022","journal-title":"Front Oncol"},{"key":"B73","doi-asserted-by":"publisher","first-page":"102222","DOI":"10.1016\/j.clgc.2024.102222","article-title":"A single institution experience in the management of localized neuroendocrine carcinoma of the bladder","volume":"22","author":"Liveringhouse","year":"2024","journal-title":"Clin Genitourin Cancer"},{"key":"B74","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2016.09.005","article-title":"Small-cell carcinoma of the bladder: 20-year single-institution retrospective review","volume":"15","author":"Jung","year":"2017","journal-title":"Clinical Genitourinary Cancer"},{"key":"B75","doi-asserted-by":"publisher","first-page":"4951","DOI":"10.3390\/cancers15204951","article-title":"Selection of chemotherapy in advanced poorly differentiated extra-pulmonary neuroendocrine carcinoma","volume":"15","author":"Weaver","year":"2023","journal-title":"Cancers"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.220","article-title":"Management of small cell carcinoma of the bladder: Consensus guidelines from the Canadian Association of Genitourinary Medical Oncologists (CAGMO)","volume":"7","author":"Moretto","year":"2013","journal-title":"Canadian Urological Association Journal"},{"key":"B77","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2019.12.014","article-title":"Adjuvant chemo-radiation therapy provided good local control and survival for a young patient with advanced urachal carcinoma: A case report and literature review","volume":"18","author":"Li","year":"2020","journal-title":"Clin Genitourin Cancer"},{"key":"B78","doi-asserted-by":"publisher","DOI":"10.3892\/mco.2019.1865","article-title":"Metastatic urachal cancer treated effectively with gemcitabine\/cisplatin combination chemotherapy and radiotherapy: A case report","volume":"11","author":"Yaegashi","year":"2019","journal-title":"Mol Clin Oncol"},{"key":"B79","doi-asserted-by":"publisher","DOI":"10.1177\/20363613231189984","article-title":"Treatment approaches for urachal cancer: Use of immunotherapy and targeted therapies","author":"Benjamin","year":"2023","journal-title":"Rare Tumors"},{"key":"B80","doi-asserted-by":"publisher","first-page":"615","DOI":"10.3390\/cancers14030615","article-title":"Immune microenvironment characteristics of urachal carcinoma and biological function of PD-L1 in urachal carcinoma cells","volume":"14","author":"Zhang","year":"2022","journal-title":"Cancers (Basel)"},{"key":"B81","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.euros.2022.02.009","article-title":"Current management of urachal carcinoma: An evidence-based guide for clinical practice","volume":"39","author":"Loizzo","year":"2022","journal-title":"European Urology Open Science"},{"key":"B82","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.eururo.2022.06.016","article-title":"The 2022 WHO classification of tumours of the urinary system and male genital organs \u2013 an update","volume":"82","author":"Moch","year":"2022","journal-title":"Eur Urol"},{"key":"B83","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1801946","article-title":"Nivolumab plus ipilimumab in small-cell lung cancer","volume":"378","author":"Hellmann","year":"2018","journal-title":"New Engl J Med"},{"key":"B84","doi-asserted-by":"publisher","DOI":"10.5858\/2009-0583-RAR.1","article-title":"Neuroendocrine tumors of the lung: an update","volume":"134","author":"Rekhtman","year":"2010","journal-title":"Arch Pathol Lab Med"},{"key":"B85","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1038\/nrendo.2011.120","article-title":"Neuroendocrine neoplasms of the gut and pancreas: new insights","volume":"8","author":"Rindi","year":"2011","journal-title":"Nat Rev Endocrinol"},{"key":"B86","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-18-4070","article-title":"FDA Approval Summary: Pembrolizumab for the treatment of microsatellite instability-high solid tumors","volume":"25","author":"Marcus","year":"2019","journal-title":"Clin Cancer Res"},{"key":"B87","doi-asserted-by":"publisher","DOI":"10.21037\/tcr.2016.12.28","article-title":"Urachal carcinoma: towards a precision medicine","volume":"5","author":"Mennitto","year":"2016","journal-title":"Trans Cancer Res"},{"key":"B88","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1038\/s41698-024-00795-4","article-title":"Comprehensive analysis of targetable mutations and tumor microenvironment in urachal cancer","volume":"9","author":"Benjamin","year":"2025","journal-title":"NPJ Precis Oncol"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1676835\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T05:16:12Z","timestamp":1763010972000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1676835\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,13]]},"references-count":88,"alternative-id":["10.3389\/fendo.2025.1676835"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1676835","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,13]]},"article-number":"1676835"}}