Prolonged Remission in a Patient with Transitional Cell Carcinoma of the Bladder Developing Brain Metastases after Systemic Chemotherapy: A Case Report

We report a case of an excellent response to M-VAC chemotherapy in a patient with pulmonary metastases from transitional cell carcinoma of the bladder. He subsequently presented with acute neurological symptoms seven weeks after the completion of chemotherapy. Computed tomography of the brain revealed a solitary 24 mm x 26 mm lesion in the frontal lobe. The brain metastasis was resected. The patient was closely followed for disease progression and showed no evidence of disease up to 42 months after surgery. The presentation and treatment policy are discussed. This case suggests that long-term remission may be obtained after surgical resection of a single brain metastasis in patients with disseminated urothelial cancer who completely responded to systemic chemotherapy.