Complex mucinous cystadenoma of undetermined malignant potential of the urachus

Urachal mucinous neoplasms are rare and include both villous adenomas and invasive adenocarcinomas. These mucinous tumours should be completely excised as they can demonstrate aggressive clinical behaviour, including the development of pseudomyxoma peritonei. We describe a 70-year-old woman who presented with a lower abdominal mass and received a diagnosis of a rare, complex urachal mucinous cystadenoma of undetermined malignant potential. This tumour demonstrated extensive mucin extravasation into perivesical soft tissue, but was not associated with pseudomyxoma peritonei or any malignancy. Rarely described in the English literature, mucinous cystadenomas of the urachus should be treated similarly to their villous adenoma counterparts: with complete surgical excision to prevent local tumour recurrences.