Psoas metastasis of urothelial carcinoma: A rare case

Urothelial carcinoma (UC) is a common malignancy with a high propensity for metastasis, typically to the lungs, liver, bones, and lymph nodes. Metastasis to the psoas muscle is exceedingly rare and poorly documented.

We report a 46-year-old chronic smoker with a history of muscle-invasive bladder UC treated with cystectomy and urinary diversion. After two years of lost follow-up, he presented with hematuria, lumbar pain, and a large left psoas tumor confirmed as recurrent UC. Surgical resection of the psoas and excretory tract tumor was performed, coupled with nutritional and rehabilitative support.

Psoas metastasis in UC represents a diagnostic and therapeutic challenge. A multimodal approach, including surgery, systemic therapy, and supportive care, can improve outcomes. Literature emphasizes poor prognosis in multifocal or visceral metastases, underscoring the aggressive nature of advanced UC.

This case highlights the importance of comprehensive imaging and multidisciplinary care in managing rare UC metastases. Further research is needed to refine treatment strategies and improve outcomes.