# Cutaneous Metastasis Following a Six-Year History of Bladder Urothelial Carcinoma in Situ: A Case Report

## TL;DR

A 67-year-old patient with bladder cancer developed rare skin metastases six years later, leading to severe complications and death.

## Contribution

This case report highlights the rare occurrence of cutaneous metastasis from bladder urothelial carcinoma in situ.

## Key findings

- Cutaneous metastasis occurred six years after initial diagnosis of bladder urothelial carcinoma in situ.
- The patient developed ulcerating lesions and sepsis, which led to death.
- The case illustrates the potential for delayed metastasis in bladder cancer patients.

## Abstract

Bladder cancer with cutaneous metastasis is a rare manifestation of the advanced stage of the disease. It can result from direct invasion, lymphatic or hematogenous spread, or iatrogenic implantation. We present a case of a 67-year-old patient initially diagnosed with urothelial carcinoma (UC) in situ of the bladder, who underwent transurethral resection of bladder tumor, along with induction and maintenance Bacillus Calmette-Guerin immunotherapy. Six years post-diagnosis, the patient developed multiple ulcerating fungating lesions in the right lower extremity, confirmed as metastases from UC. The patient additionally developed right foot gangrene with subsequent infection, which progressed into sepsis and caused the patient’s demise.