The incidence of metastatic bladder cancer from a distant organ is quite rare. A sixty five-year old man visited our hospital complaining of painless gross hematuria. He had undergone radical subtotal gastrectomy with lymph node dissection and 6 cycles of postop- erative adjuvant chemotherapy for advanced gastric carcinoma ten months earlier. Cystogram and abdominopelvic CT scan howed contrast enhanced mass mainly located in superoanterior aspect of bladder walL The upper endoscopy and abdominal CT scan revealed no evidence of recurrence in primary site. Bleeding from bladder mass was successfully controlled with electrocauterization under direct vision of cystoscopy. This case was diagnosed as metastatic adenocarcinoma of urinary bladder from gastric cancer by cystocopic biopsy and cytologic examination of urine. The cell type and degree of differentiation was exactly identical between the tissue obtained from stomach during gastric cancer surgery and that obtained from blad- der by cystoscopic biopsy. Therefore, when urologic symptoms are newly developed to the patients who had malignancy of digestive organ, metastatic malignancy of urogenital organs should be considered, even though it is very rare. Herein, we report a case of metastatic urinary bladder cancer from advanced gastric carcinoma which occurred ten months after radical surgery.
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