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Case Report
A unique case of sequential superficial bladder cancer with solitary pulmonary metastasis achieving long-term disease-free survival post-metastasectomy: A case report and literature review
1 MRCS, Fellow in Urology, Urology Department, Scunthorpe General Hospital, Northern Lincolnshire and Goole NHS Foundation Trust, Scunthorpe city, UK
2 MSc, MD, MRCS, USMLE, Lecturer in Urology, Urology Department, Scunthorpe General Hospital, Northern Lincolnshire and Goole NHS Foundation Trust, Scunthorpe city, UK
3 MSc, FRCS, Consultant in Urology, Urology Department, Scunthorpe General Hospital, Northern Lincolnshire and Goole NHS Foundation Trust, Scunthorpe city, UK
Address correspondence to:
Ramy Elbaz
Urology Department, Scunthorpe General Hospital, Northern Lincolnshire and Goole NHS Foundation Trust,
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Article ID: 100062Z15SA2026
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Alhilaly S, Elbaz R, Khan I. A unique case of sequential superficial bladder cancer with solitary pulmonary metastasis achieving long-term disease-free survival post-metastasectomy: A case report and literature review. J Case Rep Images Urol 2026;11(1):15–20.ABSTRACT
Urothelial carcinoma of the bladder most commonly metastasizes to lymph nodes, liver, bone, and lung. Solitary pulmonary metastasis from superficial (non-muscle-invasive) bladder cancer (NMIBC) is exceptionally rare. Furthermore, the long-term sequelae and subsequent cancer risk in such patients remain poorly defined. We report a case of a 76-year-old male with a history of high-grade T1 NMIBC who was found to have a solitary pulmonary nodule 19 months after completing Bacillus Calmette-Guérin (BCG) intravesical therapy. The patient underwent a successful pulmonary metastasectomy, with histopathology confirming metastatic urothelial carcinoma. He remained disease-free for seven years. Surprisingly, he then presented with de novo muscle-invasive bladder cancer (MIBC) without evidence of distant recurrence. He was managed conservatively being of old age and poor performance. This case highlights two rare phenomena: (1) the potential for superficial bladder cancer to distant metastases, and (2) the development of a new, aggressive primary tumor in the bladder long time after the control of metastatic disease. It underscores the importance of long-term, multidisciplinary surveillance for bladder cancer survivors, the biological heterogeneity of urothelial carcinoma, and the curative potential of metastasectomy in selected patients.
Keywords: Distant metastasis, Metastasectomy, Nonmuscle-invasive bladder cancer, Survival
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Acknowledgments
The authors would like to express their sincere gratitude to the Urology Department, Scunthorpe General Hospital, Northern Lincolnshire and Goole NHS Foundation Trust for facilitating clinical data collection.
Also, they would like to thank the patient for agreeing to participate in the study. No AI generative technology has been used.
Author ContributionsShatha Alhilaly - Conception of the work, Design of the work, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Ramy Elbaz - Acquisition of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Israr Khan - Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2026 Shatha Alhilaly et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
