Solitary cerebellar metastasis from bladder cancer
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Department of Urology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
Konrad Majcherczyk   

Oddział Kliniczny Urologii, Wydział Nauk Medycznych w Katowicach, Śląski Uniwersytet Medyczny w Katowicach, pl. Medyków 1, 41-200 Sosnowiec
Ann. Acad. Med. Siles. 2021;75:123–127
Brain metastases are quite rare in the course of bladder cancer and occur in only 1–7% of these patients. In most cases, cerebral metastases are secondary to visceral and lymph node metastases. A single cerebellar metastasis as the primary manifestation of transitional cell carcinoma (TCC) has only been reported in few cases. A 55-year-old man presented to the hospital with persistent headaches, accompanied by nausea and balance disturbance lasting for three weeks. Computed tomography (CT) of the head revealed a nodular lesion measuring 28 x 24 x 22 mm in diameter, located in the cerebellar vermis. Subsequently, a CT scan conducted of the chest, abdominal cavity and lesser pelvis revealed a tumor in the urinary bladder with concomitant right hydronephrosis. No lymphadenopathy nor signs of other metastases were found. Craniotomy with complete tumor resection and external ventricular drainage was performed. The patient underwent transurethral electroresection of the bladder tumor involving the right part of the bladder trigone with the right ureteral orifice and the right bladder wall. The histopathological and immunohistochemical examination of both the cerebellar and bladder tumors confirmed high grade muscle invasive bladder cancer (T2, HG). Based on these findings, the patient was diagnosed with cerebellar metastasis from primary bladder cancer. The patient did not consent to the proposed cystectomy and was transferred to the oncology department where he was qualified for brain and pelvic radiotherapy and subsequent systemic chemotherapy. This case is an example that bladder cancer (stage T2) may develop without urologic symptoms.
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