title: Metastatic bladder transitional cell carcinoma presenting as a vascularised cutaneous right arm lesion.
abstract: A 65-year-old man presented to the emergency department with a 3-week history of a fast-growing and painful mass in his right antecubital fossa. He felt otherwise well. Four months earlier, he had undergone a radical cystectomy for transitional-cell carcinoma (TCC) of the bladder (grade 3, stage pT1). Two months after the cystectomy, at another hospital, he was diagnosed with, and treated for, a pseudoaneurysm in his right antecubital fossa. Duplex ultrasonography of the presenting lesion revealed a highly vascularised mass with no pseudoaneurysm. Histological and immunohistochemical analysis preceded a diagnosis of cutaneous metastatic TCC. Whole-body CT revealed widespread metastases. This is the first reported case of a highly vascularised cutaneous lesion being the presenting feature of metastatic bladder TCC.
authors.affiliation: Imperial Vascular Unit, Imperial College London, Charing Cross Hospital, London, W6 8RF, UK. p.weston@doctors.org.uk
authors.forename: Philip S J
authors.initials: PS
authors.lastname: Weston
authors.forename: Chung S
authors.initials: CS
authors.lastname: Lim
authors.forename: Joseph
authors.initials: J
authors.lastname: Shalhoub
authors.forename: Alun H
authors.initials: AH
authors.lastname: Davies
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis; D001132:Arm; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D012867:Skin / Q000000981:diagnostic imaging / Q000473:pathology*; D012878:Skin Neoplasms / Q000175:diagnosis / Q000556:secondary*; D014463:Ultrasonography; D001749:Urinary Bladder Neoplasms / Q000473:pathology*