A 65-year-old Japanese woman underwent
radical cystectomy and right
nephroureterectomy for muscle-invasive
bladder cancer. A left ureterocutaneostomy was constructed for
urinary diversion. There was no evidence of recurrence for 4 years after the surgery. At 54 months after the surgery, however, she was referred with a chief complaint of painless skin erosion around the stoma. An incisional biopsy of the lesion showed no evidence of
malignancy. Thereafter, the lesion was treated as a benign skin erosion. However, the erosion expanded over the next 4 months, and a second incisional biopsy revealed that the erosion was overlying malignant cells. Computed tomography showed a skin
tumor of 4 cm in diameter. No other
metastases were revealed on whole-body imaging examinations. Urine cytology was negative. A skin
tumor extirpation was performed, and the specimen showed that the skin
tumor consisted of malignant growth of papillary cells adjacent to the ureter, which were identical to those of the primary
bladder cancer. A malignant component was not observed in the lumen of the resected ureter. No evidence of disease was observed in the first 3 months after extirpation. Reports of solitary skin
metastasis from
bladder cancer are rare, and only a few cases have been reported in the English literature. Because skin
metastasis from
bladder cancer can mimic a number of different benign conditions, a high index of suspicion may be necessary to make a definitive diagnosis.