Implantation metastasis after a suprapubic catheter in a case of bladder cancer

We report about a patient who was treated with a percutaneous suprapubic cystostomy in order to relieve repeated urinary retention. Two hours later a bladder tumor was found and the suprapubic catheter was removed. After transurethral resection of the bladder tumor the histological specimen showed a pT3 G3 squamous cell carcinoma. Because of the age and reduced performance status of the patient a radical cystectomy was contraindicated. In a second approach we performed again a transurethral resection of the bladder tumor simultaneously with a resection of the prostate. Eight weeks later the patient was admitted to our hospital because of reduced performance status and gross haematuria. We found a widespread bladder tumor with an implantation metastasis in the abdominal wall at the site where the suprapubic catheter was placed and multiple lung metastases. The patient died within one week after admission. The literature is reviewed and therapeutic strategies are discussed.