Urothelial carcinoma metastasis to the appendix as the first manifestation of dissemination after radical cystectomy: A case report

Urothelial carcinoma of the urinary tract is the seventh most commonly diagnosed cancer in men and the 10th most common when both genders are considered. The most common site of malignancy in the urinary tract is the bladder. Radical cystectomy with urinary diversion is considered the best treatment option for patients with advanced urothelial bladder cancer. The most common long-term complication of urinary diversion is the deterioration of renal function, mainly caused by uretero-enteric strictures. Malignant neoplasms of the appendix are rare and metastatic involvement of the appendix during the course of any neoplastic disease is very rare. The current study presents a unique case of a 67-year-old man with urothelial cancer metastasis to the appendix, which was accidentally detected in an inflamed appendix removed during surgical treatment of an uretero-enteric stricture after radical cystectomy. To the best of our knowledge, bladder cancer metastasis to the appendix has not been previously reported as the first manifestation of dissemination. This case report provides evidence expanding the spectrum of known forms of metastatic urothelial carcinoma and may help in the development of guidelines for the surveillance and treatment of bladder cancer.