Skull metastasis in urothelial cell carcinoma of the bladder

Urothelial cell carcinoma of the urinary bladder with metastasis to the skull is extremely rare. We present a case of occipital bone metastasis arising from a previously verified bladder urothelial carcinoma. An 81-year-old woman presented with a painless, nonpulsatile mass in the left occipital region of the scalp that had progressively increased for 1 year. Skull radiography demonstrated a large osteolytic lesion in the left occipital bone. Computed tomography of the head showed a 6.5 cm × 6.0 cm skull defect from the midline to the left occipital bone, overlying the posterior superior sagittal sinus. The patient underwent a wide craniectomy with en bloc removal of the mass. Because of widespread disease, the patient died 3 months after surgery.