Metastatic bladder cancer presenting as duodenal obstruction.

INTRODUCTION Bladder cancer is a common malignancy but presentation with metastatic disease is rare. This is the fi rst reported case of duodenal obstruction as a presentation of metastatic bladder cancer. CLINICAL PICTURE A middle-aged woman presented with nausea, vomiting, weight loss and intermittent haematuria. Radiology and histology confirmed metastatic bladder cancer to the retroperitoneum encasing the duodenum and causing obstruction. TREATMENT Insertion of a duodenal stent relieved the obstruction and palliative chemoradiotherapy was initiated. OUTCOME The patient died 15 months after diagnosis. CONCLUSIONS Clinicians and radiologists should be aware of atypical presentations of common malignancies.