Solitary calcaneal metastasis in superficial bladder carcinoma

We report a case of a solitary calcaneal metastasis in a patient with super ficial bladder carcinoma. The patient underwent transurethral tumour resect ion twice because of local recurrence. Both histologic examinations reveale d a grade 2 PT1 superficial transitional cell carcinoma of the bladder. The metastasis was detected four months after the initial cystoscopy due to se vere leg pain. The lesion was curetted and filled with bone cement. A year later, a below knee amputation was performed because of local recurrence. T his case deserves special attention, for two reasons. First, metastatic car cinoma to the bones of the foot is very rare. Although bony metastasis by t ransitional cell carcinoma of the bladder can be seen, presenting as a symp tomatic solitary lesion after superficial bladder carcinoma is extremely un usual. Second, failure to control bladder tumours by local means might be a n indication for an early cystectomy, even in tumours with no evidence of m uscle invasion, in order to prevent distant metastasis.