A RARE CASE OF SOLITARY PULMONARY METASTASIS IN A TREATED CASE OF TRANSITIONAL CELL CARCINOMA OF THE URINARY BLADDER

Background: Transitional cell carcinoma (TCC) of urinary bladder usually does not present with solitary pulmonary metastasis. These tumors either recur locally or manifest with multiple disseminated metastatic deposits. So far, no cases have been reported in literaturewith such findings. However, this is the first report related to solitary pulmonary metastasis in a patient, already treated for transitional cell carcinoma of urinary bladder. Case presentation: The present study reports a case of 50-year male patient who was initially diagnosed to have muscle invasive urothelial carcinoma (transitional cell carcinoma; TCC) of urinary bladder(muscle invasive, pT2N0M0) in May 2013 and underwent radical cystectomy with ileal conduit diversion followed by adjuvant chemotherapy . Patient was in regular follow up till July 2016 (disease free interval of 3 years) when computerised tomography (CT) scan of the chest revealed solitary right middle lobe pulmonary metastasis. Distant metastasis was ruled out. Image Guided biopsy of lung lesion showed metastatic TCC. Final diagnosis of TCC in lung metastasis was histopathologically identified, subsequent to right middle lobectomy. Patient had been on regular follow up till July 2016 when on CT scan no local, loco-regionalor distant metastasis was noticed. Conclusions: Although, it is rare that transitional cell carcinoma of urothelium metastasize to lung making a solitary soild lesion, the treating physician must be aware of this entity and primary surgical removal should be strongly considered in patients with good performance status .