| Summary: | Introduction: Since breast cancer is the most common non-skin cancer in women and the second most common cause of cancer death in women, it is important to understand potential sites of metastasis, including rare sites that have not frequently been reported in the literature. As our cancer interventions improve, patients will live longer and we will potentially see unusual patterns of metastatic disease more frequently, as in our case of a woman with breast cancer metastasis to her urinary bladder. Case presentation: We report a case of a 77-year-old female with history of breast cancer, metastatic to bone, and recently diagnosed bilateral hydronephrosis, secondary to a new urinary bladder mass. This mass presented 30 years after her initial cancer diagnosis and biopsy confirmed that the origin was most likely metastatic pleomorphic lobular carcinoma of breast origin. Discussion: This case raises the possibility that unusual patterns of cancer metastasis may become more common, as life expectancy of cancer patients increases. This creates unique diagnostic and management challenges for radiologists and all members of the health care team. Keywords: Breast cancer, Metastasis, Bladder, Bilateral Hydronephrosis
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