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A 60-year-old man was evaluated for new urinary symptoms after a urine PCR test suggested tuberculosis. Further testing showed kidney-function impairment, swelling of both urinary drainage systems and a diffusely thickened, small-capacity bladder. CT also showed thickening of the stomach, omentum and bladder with ascites.
A bladder biopsy revealed poorly differentiated adenocarcinoma with features suggesting an upper gastrointestinal origin rather than a primary bladder cancer. Upper endoscopy then found an ulcer along the lesser curvature of the stomach. Biopsy confirmed primary poorly differentiated signet-ring cell adenocarcinoma of the stomach.
The bladder tumor was therefore interpreted as metastatic gastric cancer, establishing Stage IV disease with a rare urinary-bladder metastatic site. He began palliative chemotherapy for the metastatic gastric cancer.
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
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