Metastasis from transitional cell carcinoma of urinary bladder as cystic pulmonary lesion.

Pulmonary metastases from transitional cell carcinoma usually present as multiple nodules, solitary mass, or interstitial micronodules but rarely manifested as cystic pulmonary lesions. We report an atypical case of multiple cavitating pulmonary metastases from transitional cell carcinoma of urinary bladder. Infectious disease is ruled out by sputum examination, laboratory exams and failure of response to antibiotic therapy. In closure, the need to exclude a second primary tumor led us to perform a fine-needle aspiration biopsy by which metastatic transitional cell carcinoma was diagnosed. Inadequacy of blood supply with necrosis may be advocated as possible mechanism of cavitations of the lesion.