The primary adenocarcinoma of bladder is a rare cancer and it was known that the prognasis is poor. The primary adenocarcinoma of bladder is divided by its embriological orign: I) nonurachal carcinoma derived from transformation of bladder epithelium, 2) urachal carcinoma arising from urachal remnant. This report represent four cases of primary urachal adenocarcinoma at Yonsei University Medical College from 1971 to 1989. The commonest sign is a painless hematuria. The specific site of origin is evaluated by measns of cystocopy, ultrasonography and computerized tomography. The choice of treatment is wide surgical resection and the role of chemotheraphy and radiotheraphy is still controversial. Our first two cases were treated only conservatively in advanced stages. The third cases was treated by curative resection and postoperative adjuvant chemotherapy. But 10 months later, intraabdominal carcinomatosis was developed. The fouth case showed metastatic lesions in both lung fields at the time of diagnosie. So we started chemotherapy of FAM regimen and a partill response was noticed after 3 cycles of chemotherapy. But after additional 3 cycles, the metastatic resions were aggrevated.
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