A case report of breast cancer metastasis to the bladder from invasive ductal carcinoma

Abstract

Introduction and importance: Breast cancer is the most common malignancy among women worldwide, predominantly manifesting as invasive ductal carcinoma (IDC), which usually metastasizes to the bones, lungs, and liver. However, metastasis to the bladder is exceedingly rare, with few documented cases and limited understanding in the existing literature.

Case presentation: A 57-year-old woman with a history of IDC presented with a lump in her left breast and was initially treated with chemotherapy and a modified radical mastectomy. Years later, she developed urinary symptoms, which upon investigation revealed multiple bladder tumors and right kidney hydronephrosis. Diagnostic imaging, including ultrasound and computed tomography (CT) scans, supported these findings.

Clinical discussion: The discovery of bladder metastasis from IDC highlights significant diagnostic challenges due to the atypical presentation. The case underscores the importance of considering unusual metastatic sites in patients with known breast cancer, especially when they present with non-specific urinary symptoms. This report explores the potential pathophysiological mechanisms of such rare metastatic occurrences and discusses the implications for clinical practice.

Conclusion: This case exemplifies the critical need for heightened awareness and thorough evaluation in patients with unusual symptoms and a history of breast cancer. It calls for more comprehensive diagnostic approaches and possibly adjusted treatment protocols to better manage atypical metastases, ultimately aiming to improve patient outcomes and contribute to a deeper understanding of metastatic breast cancer behavior.

Keywords: bladder; breast cancer; invasive ductal carcinoma; metastasis.

Figure 1

Ultrasound indicates hypoechogenicity of the posterior bladder wall.

Figure 2

(A) Venous pyelography suggests a filling defect in the cavity. (B) Venous pyelography indicates severe hydronephrosis of the right kidney.

Figure 3

Enhanced computed tomography scan indicates right kidney hydronephrosis.

Figure 4

(A) Multiple tumors in the trigone area of the bladder. (B) Tumor on the posterior wall of the bladder. (C) Tumor on the right sidewall of the bladder.

Figure 5

(A) E-Cadherin positive in tumor cells. (B) ER tumor cells negative. (C) PR tumor cells negative. (D) HER2 tumor cells negative. (F) Ki67 positive in 10% of tumor cells. (E) CK7 tumor cells positive.