A 72-year-old man with diabetes was admitted in January 2017 with complaints of lower urinary tract symptoms and microscopic hematuria. Review of the medical history showed that in 2012 he had undergone transurethral resection of a low-grade pTa bladder tumor (TURBT), without signs of recurrence until February 2017 when atypical urothelial cells were described by urine cytology and a small superfi cial bladder ABSTRACT Bladder cancer is a common cancer that may present as superfi cial,

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... or metastatic disease. Non-muscle-invasive bladder cancer (NMIBC) represents the majority of bladder cancer diagnoses, but represents a spectrum of disease with a variable clinical course, notably for signifi cant risk of recurrence and potential for progression. NMIBC metastasis to distant organs without local invasion or regional metastasis is a very rare occurrence, so there are limited case reports about early metastasis in the literature.