Abstract
Elderly patients with breast cancer often present with symptomatic, locoregionally advanced rather than screening-detected disease, thereby increasing the risk of metastatic recurrence during their remaining life time. Typical sites of metastases include lungs, bones, liver, and brain. Here we present a patient who developed a solitary urinary bladder metastasis five years after primary diagnosis of stage T4 N0 estrogen receptor-positive lobular carcinoma, while on continued adjuvant endocrine treatment (91 years of age). Anemia and increased serum creatinine resulting from hydronephrosis led to diagnosis of metastatic disease, which was confirmed by transurethral resection. The patient responded clinically to palliative radiotherapy and a different type of endocrine therapy. One year after diagnosis of metastatic disease, she died without signs of cancer progression.
Highlights
Patients with breast cancer often present with locally advanced and/or symptomatic disease because screening programs typically focus on younger women [1]
Anemia and increased serum creatinine resulting from hydronephrosis led to diagnosis of metastatic disease, which was confirmed by transurethral resection
Compared to common sites of breast cancer metastases such as lungs, bones, and liver, spreading to a large number of organs including heart [5], pancreas [6], and gastrointestinal tract is rare [7]. This is true for the urinary bladder
Summary
Patients with breast cancer often present with locally advanced and/or symptomatic disease because screening programs typically focus on younger women [1]. It has long been recognized that patients diagnosed with locally advanced disease face a higher risk of metastatic recurrence during the course of disease [2]. Autopsy series from the last century showed that most distant metastases are located in the lymph nodes, lungs, pleura, bones, adrenal glands, liver, and brain [3]. Other organs such as pituitary gland, kidneys, uterus, and thyroid gland might be affected. The urinary bladder is a very rare site of distant relapse [4]. We report the clinical course of a patient with solitary metastasis to the urinary bladder
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