Advanced bladder tumor rarely metastasize to the skin. This is a result of intraperitoneal spread at least microscopically, determining a poor prognosis. We report 73 year old man who presented with skin lesion from pT2 urothelial carcinoma of the bladder. Skin biopsy revealed features of infiltrating urothelial carcinoma. In immunohistochemistry, proliferation expresses CK7 diffusely and CK20 more heterogeneously. It also expresses GATA3 expression of P63. Abdominal-pelvic CT reveled a focal thickening of the bladder dome on the right side of the body, extending over 6 cm and with a maximum thickness of 18 mm, with bilateral pyelocalic dilatation. Patient was referred to oncology for platinum-based chemotherapy. He had responded well to chemotherapy with stable lesions. In any patient followed for a bladder cancer, an atypical skin lesion should raise the alarm and make the patient seek a dermatological opinion for suspicion of a skin metastasis despite its rarity.
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