Cutaneous Metastasis of Bladder Cancer

Citation: Mounia B, Selma B, Sara E, Zakia D, Hanane B, et al., Cutaneous Metastasis of Bladder Cancer. Biomed J Sci & Tech Res 26(5)-2020. BJSTR. MS.ID.004410.


Introduction
Skin meta stases (SM) are infrequent secondary locations of deepneoplasia that can sometimes be indicative of primary cancer.
The kidneyis the most common organ to serve as a source of meta stasis to the skin [4]. Bladder cancers are lesslikely to metastasize to the skin We report a new case of skin metastases presenting as a large tumor in the thoraciclevel in a patient followed for a urothelial carcinoma of the bladder.

Discussion
Only 5.3% of all malignancies lead to cutaneous metastasis. Out of these, 1.34% are linked to underlying genitourinary malignancy; bladder cancer accounts for 0.84% of these [5] with a limited number of published cases, It usually metastasizes to regional lymphnodes, liver, lungs and bones [1] Large 20-year retrospective Taiwanese study found only 2 cases of skin meta stases among 911 patients with bladder and ureter cancer [6] and Kishi et al. [7] reported that 66.7% of patients with T3 and T4 tumors had metastatic disease Cutaneous involvement from bladder cancer is achieved by direct tumor invasion, hematogenous routes, lymphatic spread, and direct seeding due to iatrogenic implantation [8]. Iatro genic implantation is the most common cause of seeding outside of the urinary tract [9] anditsdue to surgical treatment of these tumors, includingcy stectomy, partial cystectomy, TURBT, and other procedures [8].
The clinical appearance of these lesions varies and maymimicother dermatologic diseases. The lesionscanbesolitary or multiple, and can have anodular, fibrotic, and inflammatory appearance [8].
In urological cancer withcutaneousmetastasis, several aspects have been described in the literature, like , A cutaneousery sipelas-likelesion [10] Zosteri form cutaneous metastases [11] or Herpetiform cutaneous metastases [12], butthe most common clinical picture is aninfiltrated plaque or nodule [10] Ul cerated swelling, subcutaneous nodules, violaceous papules, and ulcerated plaques have been reported [1] in our patient the appearance was that of a large tumor withulcerated surface Dermoscopy of skin metastases has been recently reported in the literature [13], the mostreported sign was a polymorphic vascularization made of arborising vessels, as well as serpiginous, but these aspects were not retained as specific, sincethey canbe found even in front of a primary skin tumor, such as melanoma or squamous cell carcinoma.
Local excision, radiotherapy, chemotherapy, immunological and combination therapy have been reported in previous studies [14].
Due to the poorout comes of these patients, the treatment options are limited and primarily supportive in nature. The prognosis of any cancer with cut aneous metastasisis poor; with regard to bladder cancer with cutaneous metastasis, median survival time is< 12 months [10].

Conclusion
We report a new case of skin metastasis of a bladder tumor, in the form of a pigmented tumor in a patient with multiple visceral metasases. Although cutaneous metastasisis a rare dermatological condition, cutaneous metastasis should be included in the differential diagnosis of tumo allesion. Skin biopsy should be performed to preventmis diagnosis. For the patients with urologic malignancies, we suggest that all urologists should increase attention to the physical examination of the skin because skin lesion scanbe the first sign of silent or recurrent urologic malignancies.