• Vol. 38 No. 10, 914–915
  • 15 October 2009

Metastatic Bladder Cancer Presenting as Duodenal Obstruction



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Introduction: Bladder cancer is a common malignancy but presentation with metastatic disease is rare. This is the first reported case of duodenal obstruction as a presentation of metastatic bladder cancer. Clinical Picture: A middle-aged woman presented with nausea, vomiting, weight loss and intermittent haematuria. Radiology and histology confirmed metastatic bladder cancer to the retroperitoneum encasing the duodenum and causing obstruction. Treatment: Insertion of a duodenal stent relieved the obstruction and palliative chemoradiotherapy was initiated. Outcome: The patient died 15 months after diagnosis. Conclusions: Clinicians and radiologists should be aware of atypical presentations of common malignancies.

Bladder cancer is the most common malignancy of the urinary tract. Peak incidence is in the 6th and 7th decades although recent trends have shown an increase among younger patients.1 The majority of patients present with lower urinary tract symptoms, the most frequent of which is painless haematuria. Presentation with metastatic disease is rare and is most likely in association with aggressive invasive tumours. We report a case of duodenal obstruction as a first manifestation of metastatic bladder cancer. To our knowledge this is the first case reported in the literature.

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