A rare case of seminoma metastasis to the bladder

Introduction. The great majority of testis neoplasms are germ cell tumours. The most common site of metastasis is the retroperitoneal region. Metastasis to the bladder is very rare. Clinical case. A 33-year-old male smoker had right radical orchiectomy two years ago for seminoma. The investigations then showed right retroperitoneal and iliac enlarged nodes and right renal hydronephrosis. Nephrostomy tube was inserted, chemotherapy was given with good response. Two years later the patient presented with right flank pain, hematuria and lower urinary tract symptoms. MRI showed a big bladder mass. Cystoscopy and transurethral resection were done and showed metastatic seminoma. Discussion. Testicular tumours are the most common male malignant neoplasms between the ages of 15 and 35 years. The great majority of testicular neoplasms are germ cell tumours and seminomas are the most common type of this group. Urinary system metastasis is quite rare. Conclusion. Rare and late metastases to the bladder should always be considered, and careful medical history should be taken.