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To review the most unusual locations of metastases of urothelial origin following a case of metastasis in iris of a patient with muscle-invasive bladder carcinoma.
Material and methods:
We describe the case of a 77-year-old man diagnosed with muscle-invasive bladder neoplasia (T2bG3) who presented a single lesion in the body of the iris compatible with metastasis of urothelial origin.
This is a 77-year-old male patient who is diagnosed by bladder transurethral resection of muscle-invasive bladder carcinoma, and in the extension study using computed tomography (CT) lymph node metastases in the pelvis, multiple lungs, bone at the head of the femur and synchronous kidney tumor of possible urothelial origin were descrived. During the course of his diagnosis, he went to the emergency room for a painful red eye, observing a single erythematous lesion with superficial neovascularization in the iridian margin, considering as the first diagnostic possibility acute anterior uveitis (AAU). After the treatment administered, the patient experienced a notable clinical improvement despite persisting in the iris of the lesion described, this time considering as the first diagnostic possibility ocular metastasis of his primary tumor. Fine needle aspiration of the lesion was performed, obtaining an immunohistochemical study positive for CK7 marker of urothelial origin, accepting this diagnostic possibility. After the initiation of treatment with systemic chemotherapy and ocular antiangiogenic therapy, the lesion remitted after 2 months.
The metastasis in iris of urothelial origin is an extremely infrequent location, finding only two published cases of iris metastasis of muscle-invasive bladder cancer diagnosed by cytologies with similar aspects.