Sarcomatoid bladder carcinoma: A rare metastatic disease of small bowel

Introduction: Small bowel obstruction secondary to metastatic disease is a rare presentation with most current evidence being limited to case reports. Previous evidence described breast, lung and melanoma as the most common underlying primaries presenting with this entity. Bladder carcinoma rarely metastasizes to the gastrointestinal tract, and if present, does not typically cause small bowel obstruction. Case Report: A 62­year­old female with a history of sarcomatoid bladder carcinoma that had been managed initially by transurethral endoscopic resections and subsequently by a radical cystectomy presented a year later with small bowel obstruction. Extensive work­up for the source of the obstruction was inconclusive and after failed conservative management, the patient underwent an exploratory laparotomy. At laparotomy, she was found to have a small bowel intussusception secondary to a tumor. The small bowel resection specimen was later identified as a sarcomatoid carcinoma, resembling the previously resected bladder tumor. Conclusion: We present a rare case of a patient presenting with small bowel obstruction secondary to metastatic disease from a variant of bladder cancer—the sarcomatoid bladder carcinoma.