# Bladder Metastasis From Lung Adenocarcinoma: A Rare Case

**Authors:** Nicola Fazaa, Etan Eigner, Inbal Farkash, Gilad Amiel, Azik Hoffman

PMC · DOI: 10.7759/cureus.83434 · Cureus · 2025-05-03

## TL;DR

A rare case of lung cancer spreading to the bladder is reported, emphasizing the need for accurate diagnosis to avoid misidentification as bladder cancer.

## Contribution

This paper presents a rare clinical case of bladder metastasis from lung adenocarcinoma and underscores diagnostic considerations.

## Key findings

- Bladder metastasis from lung adenocarcinoma is rare and often misdiagnosed as primary bladder cancer.
- Histopathology and immunohistochemistry confirmed metastasis with TTF-1+/CK7+/CK20-/GATA3- profile.
- The case highlights the importance of considering metastasis in patients with advanced cancer and new urinary symptoms.

## Abstract

Bladder metastasis from primary lung adenocarcinoma is an infrequent clinical entity. Due to its rarity and nonspecific presentation, it is often misdiagnosed as primary urothelial carcinoma. We report the case of a 65-year-old male with a history of metastatic lung adenocarcinoma presenting to the emergency room with sudden gross hematuria. Imaging revealed a new bladder lesion. Following transurethral resection, histopathological and immunohistochemical analysis confirmed metastatic lung adenocarcinoma (thyroid transcription factor-1-positive/cytokeratin 7-positive/cytokeratin 20 negative/GATA binding protein 3-negative or TTF-1+/CK7+/CK20-/GATA3-). The case was discussed at the Genitourinary Oncology Tumor Board, and given the prognosis of metastatic lung adenocarcinoma, the patient opted for palliative care. This case highlights the importance of considering metastatic spread to the urinary bladder in patients with advanced malignancy who develop new urinary symptoms. Accurate diagnosis through histopathology and immunohistochemistry is essential for guiding appropriate management.

## Linked entities

- **Proteins:** TTF1 (transcription termination factor 1), KRT7 (keratin 7), KRT20 (keratin 20), GATA3 (GATA binding protein 3)
- **Diseases:** lung adenocarcinoma (MONDO:0005061), urothelial carcinoma (MONDO:0040679)

## Full-text entities

- **Genes:** GATA3 (GATA binding protein 3) [NCBI Gene 2625] {aka HDR, HDRS}, TTF1 (transcription termination factor 1) [NCBI Gene 7270] {aka TTF-1, TTF-I}, NKX2-1 (NK2 homeobox 1) [NCBI Gene 7080] {aka BCH, BHC, NK-2, NKX2.1, NKX2A, NMTC1}, KRT7 (keratin 7) [NCBI Gene 3855] {aka CK7, K2C7, K7, SCL}, KRT20 (keratin 20) [NCBI Gene 54474] {aka CD20, CK-20, CK20, K20, KRT21}
- **Diseases:** bladder lesion (MESH:D001745), Lung Adenocarcinoma (MESH:D000077192), urothelial carcinoma (MESH:D014523), hematuria (MESH:D006417), Tumor (MESH:D009369), Bladder Metastasis (MESH:D009362)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12130347/full.md

## References

17 references — full list in the complete paper: https://tomesphere.com/paper/PMC12130347/full.md

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Source: https://tomesphere.com/paper/PMC12130347