Unusual Presentation of Cutaneous Metastasis from Bladder Tumour: Two Case Reports of Rare Implantation

Cutaneous metastasis from the transitional cell carcinoma (TCC) of the bladder is extremely rare. This paper describes two uncommon cases of patients presented with a single fast-growing skin lesion accompanied by pain. The first case involved a 55-year-old male patient with a lesion in the anterior abdominal wall who underwent radical cystectomy five months earlier. The second case involved a 70-year-old female patient with a single, nodular bleeding skin lesion raised in the left submammary region that underwent radical mastectomy two years earlier. CT-scan showed a 3cm nodular solid, subcutaneous lesion with contrast enhancement involving the left rectus abdominis muscle in the male patient and a 2cm nodular solid lesion to the left hypochondria suspicious for metastatic disease in the female patient. The histopathologic examination subsequently confirmed TCC metastasis in both the cases. This report highlights the importance of a high-index of suspicion of skin urothelial metastases to avoid misdiagnosis and also supports the use of immunohistochemical staining for the determination of the primary origin of the tumour.