Urachal adenocarcinoma is a rare tumor and represents 0.17–0.34% of all bladder tumors. It has an insidious course and variable clinical presentation. We present a case report of a 58 year old white male with an urachal cyst who suffered irritative voiding symptoms and long term mucusuria, since childhood. After surgical removal of the cyst with a partial cystectomy a mucus adenocarcinoma was diagnosed histologically. The patient after a negative for metastatic disease screen underwent a completion radical cystectomy with pelvic lymph node clearance. Clinicians should have a high degree of suspicion for these rare tumors.
