Open AccessSolitary second metatarsal metastasis as the first site of distant spread in TCC urinary bladder: A case report
Author(s) -
Siddharth Yadav,
Rajeev Kumar
Publication year - 2015
Publication title -
indian journal of urology/indian journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.333
H-Index - 30
eISSN - 1998-3824
pISSN - 0970-1591
DOI - 10.4103/0970-1591.163312
Subject(s) - medicine , cystectomy , metastasis , lesion , magnetic resonance imaging , metatarsal bones , appendicular skeleton , osteomyelitis , urinary bladder , cancer , radiology , bladder cancer , surgery , anatomy
Metastasis to the skeleton is uncommon in muscle-invasive carcinoma of the urinary bladder. When present, it most commonly involves the axial and proximal appendicular skeleton, and acrometastasis (metastasis to hand and foot) is very rare. We report a patient who developed a solitary metastatic lesion of the left metatarsal 2 weeks after radical cystectomy. The lack of suspicion and magnetic resonance imaging findings suggestive of inflammation led to a diagnosis of tubercular osteomyelitis and antitubercular therapy was started. The patient developed nodal metastasis and, because the foot lesion did not respond to treatment, fine needle aspiration cytology from it revealed poorly differentiated metastatic cancer.