Abstract

Bladder cancer is the 10th most common cancer type worldwide, with a median age of diagnostic of 75 years. Male sex, white race, personal history of pelvic radiation, and tobacco use are considered risk factors. Urothelial carcinoma (UC) is the most frequent histology. Squamous differentiation (SD) is the most common histologic variant in bladder cancer (20% of cases) and is associated with a worse prognosis. We presented the case of a 75-years old male patient diagnosed with high-grade (G3) UC of the bladder with SC who developed skin metastasis shortly after completing the adjuvant chemotherapy.  He was further started on 1st line immunotherapy with Atezolizumab, with good response and stable disease until this report was written (for twelve months).