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A 32-year-old woman presented with abdominal pain, frequency and dysuria of one momth’s duration. Physical examination revealed a palpable mass in the suprapubic area. Urine analysis revealed trace proteinuria and hematuria. Computed tomography showed an ill-defined peripheral enhancing mass, measuring 8x4.6x4.6cm. This mass was located in the upper vesical dome along the anterior wall of the pelvic cavity. Necrosis and irregular thick septations were noted within the mass with suspicion of infected urachal cyst. The evidence of tubo-ovarian abscess was absent. Cystectomy were performed. Grossly, the lesion was conical shaped and showed cystic change containing yellowish materials, Microscopically, abundant lipid-laden histiocytes were aggregated in the urachal cyst and inflammatory infiltration was observed in the muscle layer of urinary bladder. Many lymphocytes and neutrophils were presented. Our case was compatible with urachal xanthogranulomatous disease. Xanthogranulomatous inflammation is unusual forms of chronic inflammatory process and have been described in many anatomical sites, such as the retroperitoneum, mandible, kidney and vagina. However, xathogranulomatous disease involving urachal remnant is very rare. To our knowledge, only three cases had been reported in the world literature.
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