Bladder metastasis from renal-cell carcinoma twelve years after nephrectomy

Introduction: Metastatic disease of renal cell carcinoma usually occurs via the hematogenic or the lymphogenic pathway. Usual metastatic sites are lun g, liver, bone, brain, and adrenal gland. Metastasis to the bladder is an e xtremely rare event. In the literature it has been well documented that com plete resection of solitary and multifocal metastases, to the lung and the liver can prolong survival. Case report: We report the case of a solitary metastasis to the bladder 12 years after left-sided radical tumour nephrectomy. The patient presented wi th a mass in the bladder detected by routine ultrasound. Sonography of the right kidney was unremarkable. Cystoscopy revealed a solid tumour localised on the right side of the bladder. The tumour was completely removed by tra nsurethral resection. Histological diagnosis was metastasis from renal cell carcinoma. After a follow-up of 13 months the patient is free of symptoms and recurrence in the bladder. Conclusion: Progression of renal cell carcinoma to metastatic disease may o ccur late after primary "curative" therapy and may involve untypical locali sations such as the bladder. Complete resection of any resectable tumour sh ould be performed.