Metastatic Clear Renal Cell Carcinoma in Bladder Following Radical Nephrectomy, Metastasectomy, and Targeted Therapy: A Rare Case Report.

Bladder metastasis from renal cell carcinoma (RCC) is relatively uncommon and may occur synchronously or metachronously, potentially without clinical symptoms. Notably, cases of bladder metastasis in advanced RCC following targeted therapy were particularly rare. Here we present the case of a 50-year-old female patient who underwent radical left nephrectomy for a renal tumor. Postoperative pathology confirmed clear cell renal cell carcinoma (ccRCC). Following the development of contralateral adrenal and metacarpal metastases, our institution performed metastatic lesion resection, after which the patient received adjuvant sunitinib therapy. Follow-up PET/CT revealed additional cranial bone metastasis and a suspicious bladder wall lesion. Subsequent surgical interventions included resection of the cranial metastasis and bladder mass, with pathology confirming metastatic ccRCC. Postoperatively, the patient was treated with axitinib combined with toripalimab. Despite treatment, the disease progressed with new widespread skeletal metastases, though no bladder recurrence was observed.