Metastatic lesions of non-urological malignancies to the bladder are rare and often secondary to spread from a contiguous site. Distant metastasis to the bladder is even more uncommon. There are less than 10 previously described cases of metastatic pulmonary adenocarcinoma to the bladder in the literature over the past 20 years. In this report, we describe a 73-year-old African American gentleman with a history of prostate cancer who presented to the urology department with gross hematuria. Follow up imaging suggested possible neoplastic changes to the bladder. Biopsy and histochemical staining revealed poorly differentiated adenocarcinoma of pulmonary origin.

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