A rare case of metastatic urothelial carcinoma to the liver
Cancer of unknown primary (CUP) is a rare diagnosis and accounts for approximately 3% of all malignancies. Metastatic urothelial carcinoma with an unidentified primary tumor is rare, and to our knowledge, no other cases have been reported in the literature.

The patient is a 50 year old male with a 7.5 pack year smoking history, who presented with intermittent right upper quadrant pain of one month's duration. Abdominal ultrasound findings were consistent with acute cholecystitis, and he underwent urgent cholecystectomy. Three months postoperatively, he presented with one month of intermittent fever, malaise, and persistent right upper quadrant pain.

A computed tomography scan of the chest, abdomen and pelvis with intravenous and oral contrast revealed several liver masses. Additionally, an enlarged lymph node adjacent to the stomach was identified; however, no abnormality was present in the kidneys, ureters or bladder. Fine needle aspiration of one of the liver masses was performed and sent for immunohistochemical evaluation.

Source: Urology case reports

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