title: Metastatic bladder cancer presenting as duodenal obstruction.
abstract: BACKGROUND
  Bladder cancer is a common malignancy but presentation with metastatic disease is rare. This is the fi rst reported case of duodenal obstruction as a presentation of metastatic bladder cancer.
  
  
  METHODS
  A middle-aged woman presented with nausea, vomiting, weight loss and intermittent haematuria. Radiology and histology confirmed metastatic bladder cancer to the retroperitoneum encasing the duodenum and causing obstruction.
  
  
  METHODS
  Insertion of a duodenal stent relieved the obstruction and palliative chemoradiotherapy was initiated.
  
  
  RESULTS
  The patient died 15 months after diagnosis.
  
  
  CONCLUSIONS
  Clinicians and radiologists should be aware of atypical presentations of common malignancies.
authors.affiliation: Department of Radiology, Imperial College NHS Trust, Charing Cross Hospital, London, United Kingdom. katehawtin@doctors.org.uk
authors.forename: Katherine
authors.initials: K
authors.lastname: Hawtin
authors.forename: Alex
authors.initials: A
authors.lastname: Kent
authors.forename: Carole
authors.initials: C
authors.lastname: Collins
authors.forename: Dominic
authors.initials: D
authors.lastname: Blunt
mesh_terms: D000328:Adult; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy / Q000556:secondary*; D003937:Diagnosis, Differential; D004380:Duodenal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D010166:Palliative Care; D012186:Retroperitoneal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary*; D015607:Stents; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000473:pathology*