Metastatic adenocarcinoma of bladder presenting with skin and visceral metastasis

A 62-year-old male patient presented with multiple subcutaneous swellings over neck, axilla and scapular region for last 3 months. Further evaluation revealed the presence of bladder mass, deranged kidney function tests with multiple rounded opacities in lung. The patient was stabilised with haemodialysis and bilateral percutaneous nephrostomy tube placement. The patient was planned for multiagent chemotherapy after stabilisation but died within 2 weeks due to progressive disease. Fine needle aspiration cytology (FNAC) from the above-mentioned skin and lymph nodes swellings was suggestive of adenocarcinoma. We herein report this rare case of a metastatic adenocarcinoma of the bladder with extensive skin and visceral metastasis. The presence of skin metastasis confers a poor prognostic sign to the patient. They are usually resistant to available treatment modalities. To our knowledge, this is the first reported case of adenocarcinoma metastatic to skin and viscera.