[Bladder cancer with skin metastasis: a case report]

Area of Science:

• Urology
• Oncology
• Dermatology

Background:

• Bladder carcinoma, specifically transitional cell carcinoma (TCC), is a significant oncological diagnosis.
• Metastasis of bladder cancer to distant sites, such as the skin, is exceptionally uncommon.

Observation:

• A 68-year-old male presented with macroscopic hematuria, leading to the diagnosis of TCC of the bladder.
• The patient underwent multiple treatments including transurethral resection of bladder tumor (TURBT), intravesical chemotherapy, intra-arterial chemotherapy, and eventually a total cystoprostatectomy with neobladder formation.
• Over 13 years post-diagnosis, the patient developed multiple cutaneous nodules consistent with TCC metastasis.

Findings:

• Histopathological examination confirmed transitional cell carcinoma (TCC) with muscle invasion (pT1, G3) initially.
• Delayed diagnosis of skin metastasis occurred 13 years after the primary bladder cancer diagnosis.
• The patient's advanced age, renal dysfunction, and widespread metastases contributed to a poor prognosis, with death occurring four months after skin metastasis manifestation.

Implications:

• This case highlights the rare but possible phenomenon of late-onset skin metastasis from bladder TCC.
• It underscores the importance of considering unusual metastatic patterns in patients with a history of bladder cancer, even years after initial treatment.
• Further research into the mechanisms and risk factors for such rare metastatic presentations is warranted.