Metastatic Urothelial Carcinoma of the Bladder to the Retina: A Clinicopathological Correlation and Review of the Literature.

Abstract

To report a rare case of metastatic urothelial carcinoma of the bladder (UCB) to the retina confirmed with histopathology and compare diagnostic findings, therapeutic techniques, and prognosis to other reported retinal and ocular metastatic cases, with focus on urothelial origin. Intravenous fluorescein angiography (IVFA) was used to investigate a large yellow-white superotemporal retinal lesion OS. Two pars plana vitrectomies OS were performed yielding vitreous cytology and retinal lesion biopsy histopathology, respectively. IVFA showed overlying vitreous debris blockage, punctate hyperfluorescence consistent with light-bulb microaneurysms, patchy capillary nonperfusion, hemorrhagic blockage, and late central leakage. Vitreous cytology revealed atypical cells characterized by enlarged, pleomorphic nuclei, abundant cytoplasm, and harboring common cell borders. Retina biopsy revealed invasive irregular islands of carcinomatous cells with immunoreactivity to high molecular weight cytokeratin, uroplakin III, and GATA-3; the same cells were CK20 negative. We report the second documented case, to our knowledge, of retinal metastasis from UCB. The clinical pattern and presentation fit similarly to the first documented case.