Objective: Urothelial carcinoma with sarcomatoid differentiation is an uncommon but highly aggressive variant of bladder cancer, often diagnosed at advanced stages and associated with poor outcomes. Colonic metastasis from bladder carcinoma is extremely rare, making this case noteworthy.
Case presentation: A 68-year-old male presented with macroscopic hematuria and dysuria. Imaging revealed a bladder mass invading the perivesical tissue. Transurethral biopsy confirmed high-grade urothelial carcinoma with sarcomatoid differentiation. During preoperative evaluation, colonoscopy revealed an ulcerated mass in the ascending colon, confirmed as metastatic carcinoma with similar sarcomatoid features. The patient underwent radical cystectomy and right hemicolectomy. Despite surgery and planned chemotherapy, the patient died postoperatively due to clinical deterioration.
Conclusions: This case underscores the aggressive nature of sarcomatoid urothelial carcinoma and highlights the potential for rare metastatic patterns, emphasizing the need for multidisciplinary management in atypical presentations.
Keywords: bladder cancer, colonic metastasis, hemicolectomy, radical cystectomy, sarcomatoid tumor, urothelial carcinoma
Abstract
Objective: Urothelial carcinoma with sarcomatoid differentiation is an uncommon but highly aggressive variant of bladder cancer, often diagnosed at advanced stages and associated with poor outcomes. Colonic metastasis from bladder carcinoma is extremely rare, making this case noteworthy.
Case presentation: A 68-year-old male presented with macroscopic hematuria and dysuria. Imaging revealed a bladder mass invading the perivesical tissue. Transurethral biopsy confirmed high-grade urothelial carcinoma with sarcomatoid differentiation. During preoperative evaluation, colonoscopy revealed an ulcerated mass in the ascending colon, confirmed as metastatic carcinoma with similar sarcomatoid features. The patient underwent radical cystectomy and right hemicolectomy. Despite surgery and planned chemotherapy, the patient died postoperatively due to clinical deterioration.
Conclusions: This case underscores the aggressive nature of sarcomatoid urothelial carcinoma and highlights the potential for rare metastatic patterns, emphasizing the need for multidisciplinary management in atypical presentations.
Keywords: bladder cancer, colonic metastasis, hemicolectomy, radical cystectomy, sarcomatoid tumor, urothelial carcinoma