A 61-year-old male patient, under treatment for schizophrenic psychosis, with no other relevant medical-surgical history, presented with nonspecific abdominal discomfort and macroscopic hematuria for 6 months.
Laboratory tests revealed mild anemia with normal biochemical parameters.
On physical examination no findings of abdominal-pelvic interest were found, with urological examination suggestive of prostatic hyperplasia, with no other findings.
PSA normal.
Urine cytology was negative for malignant cells.
In the diagnostic tests performed, it was observed: cystoscopy (a single lesion in a dome, solid and with bladder voiding appearance; ultrasound and CT (rounded nodular lesion, calcified, medium line diameter).
In the CT extension study, neither thoracic nor pelvic manifestations were observed.
No lymphadenopathies.
Normal skull CT.
The patient underwent surgery, performing a partial cystectomy, postoperative course and subsequent oncological controls without incidents.
Histopathological examination of the surgical specimen showed uracal tissue with the presence of a mucosecretory adenocarcinoma (colloid) type that showed bladder wall neoplasia, compatible with uracal stenosis (stage IIIA).
Approximately 5 years after diagnosis, a rounded lung mass was first detected, which grew in subsequent controls rejecting the patient and family members by FNAC/biopsy, followed by multiple brain metastases or radiological evidence of tumor markers.
