# Uncommon Encounter in Urachus: A Rare Case of Xanthogranulomatous Urachitis With Review of Literature

## TL;DR

A rare case of xanthogranulomatous urachitis in a 48-year-old man is reported, highlighting its importance as a possible diagnosis for urachal masses.

## Contribution

This case adds to the limited global literature on xanthogranulomatous urachitis and emphasizes its clinical relevance.

## Key findings

- Histopathology confirmed xanthogranulomatous urachitis after surgical resection of the urachal mass.
- The patient's symptoms resolved postoperatively, indicating successful treatment.

## Abstract

Urachus is a fibrous remnant from embryologic development derived from the allantois, which is involved in waste elimination in the fetus. Typically, it extends from the dome of the bladder to the umbilicus. Xanthogranulomatous urachitis, or xanthogranulomatous inflammation of the urachus, is a highly unusual pathological entity characterized by large lipid‐laden macrophages, with only a few cases reported worldwide. In this case, a 48‐year‐old male patient presented with complaints of persistent abdominal pain and watery discharge from the umbilicus for 1 month. Following en bloc resection of the urachal mass, histopathology revealed findings consistent with xanthogranulomatous urachitis. The postoperative course was uneventful, and eventually, the patient recovered to baseline health with resolution of bothersome symptoms. We report a case of xanthogranulomatous urachitis, which, despite its rarity, should be considered an important differential diagnosis of all urachal masses.

Xanthogranulomatous urachitis, though rarely encountered in clinical practice, is an important differential diagnosis for urachal cancers owing to similar radiological imaging findings.