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A Rare Case of Rectal Metastasis from Sarcomatoid Variant of Urothelial Carcinoma: A Case Report

Jacklyn Yek, Po Yin Tang, Puay Hoon Tan, Chee Yung Ng, Shiong Lui Lee


Introduction: Urothelial carcinoma of the bladder with sarcomatoid differentiation is known to display aggressive biological behaviour. To our knowledge, this is the first reported case of isolated rectal metastasis from sarcomatoid urothelial carcinoma of the bladder following curative surgery.

Presentation of Case: A 72-year-old male presented with tenesmus 6 months after radical cystoprostatectomy, lymph node dissection and ileal conduit formation for pathological T1N0M0 bladder carcinoma.

Digital rectal examination revealed thickening of the distal rectum with no bleeding. Computerised tomography demonstrated thickening in the rectal mucosa and submucosa with intact perirectal fat. Rectal biopsy performed via colonoscopy confirmed metastases of urothelial carcinoma origin. The patient was treated with palliative radiation.

Conclusion: This case report illustrates an unusual location of urothelial carcinoma metastasis. A high clinical suspicion in patients with this aggressive variant of cancer is required.


bladder cancer; metastasis; rectum

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