Isolated Metastasis to the Brain From Upper Tract Urothelial Carcinoma

Isolated brain metastasis from cancers of urothelial origin are rare, especially after a long recurrence-free interval with few reports in the literature. We herein present the case of a 62 year old male with history of recurrent bladder cancers treated in 2004 and 2005 and a left distal ureteral high grade pT3aN1M0 urothelial cancer treated with distal ureterectomy and reimplant followed by adjuvant chemotherapy in 2014 who presented after a 5 year recurrence-free interval with tonic-clonic seizure. Further workup revealed an isolated 12.0 mm x 18.0 mm x 8.0 mm mass overlying the left parietal lobe with no other metastatic sites. The patient was treated with resection of the mass and adjuvant radiation therapy with pathology confirming metastatic carcinoma of urothelial origin. Though prognosis for patients with such a presentation remains poor, we provide a review of the current literature with respect to incidence, presentation and therapeutic considerations for such patients.