www.sciedu.ca/jst Journal of Solid Tumors, June 2012, Vol. 2, No. 3 Published by Sciedu Press 59 CASE REPORT Cervical lymph node metastasis from transitional cell carcinoma of urinary bladder: Case report and review of literature Mutahir A. Tunio, Mushabbab A lAsiri, Yasser Bayoumi, Mohsin Fareed, Shoaib Ahmad Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, PO 59046, Saudi Arabia Correspondence: Mutahir A. Tunio. Address: Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, PO 59046, Saudi Arabia. Telephone: 996-1288-9999. E-mail: drmutahirtonio@hotmail.com Received: February 16, 2012 Accepted: April 15, 2012 Published: June 1, 2012 DOI : 10.5430/jst.v2n3p59 URL: http://dx.doi.org/10.5430/jst.v2n3p59 Abstract The bladder cancer usually metastasizes to regional pelvic lymph nodes, lungs, liver and bones. Metastasis to non-regional lymph nodes especially cervical lymph nodes is extremely rare presentation. Metastasis to head and neck region is associated with poor prognosis and low survival rate. Here-in we report a case cervical lymph node metastasis in patient with muscle invasive bladder cancer. Key words Transitional cell carcinoma, Urinary bladder, Cervical lymph nodes, Metastasis Introduction Transitional cell carcinoma of urinary bladder is most common urologic malignancy in developing countries [1] . Common site for metastatic bladder carcinoma is regional lymph nodes, lungs, bones and brain. The most common lymph nodes involved are external, internal iliac and obturator (20%-45%) as the primary lymphatic drainage of the bladder and the common iliac sites as the secondary drainage [2] . However, lymph node metastasis above the diaphragm especially in head and neck region is extremely rare. Only few reports have been published so far and with poor prognosis [3] . We report a case of patient with transitional cell carcinoma of bladder with solitary left supraclavicular lymph nodes metastasis without any bony or visceral metastasis. Case report Fifty eight year old male, who was diagnosed as a case locally advanced muscle invasive transitional carcinoma of the bladder stage T3N0M0, underwent transurethral resection of bladder tumor (TURBT) followed by radical course of chemo-radiotherapy with total dose 6600cGy to the tumor as a bladder preserving therapy, as he deferred the option of radical cystectomy (Figure 1). After the completion of treatment he was lost to follow up.