bladder carcinoma most commonly metastasizes to the lymph nodes , liver , lungs and bones . generally rates of cutaneous metastases of malignancies have been reported as 1.02% , 5.3% and 2.9% , respectively in 3 large series [ 13 ] . in these cutaneous spread from primary urologic malignancies was reported to have a rate of 1.3% and this rate was 0.84% for bladder carcinoma . cutaneous metastasis from bladder carcinoma occurs most commonly to the locoregional area and via lymphatic drainage [ 4 , 5 ] . histopathological examination revealed a high grade ( grade 3 ) invasive urothelial carcinoma ( pt4anxm0 ) . surrounding the tumor , there was diffuse vascular embolus and perineural invasion ( fig . distant metastases were not noted in abdominal mri and thorax ct . in the first postoperative month erythematous papular lesions developed in the suprapubic region . 2 ) . physical examination revealed edema and clinically there was pain and leucocytosis and high levels of c reactive protein ( crp ) were found in the peripheral blood . it revealed cutaneous and subcutaneous edema and there were numerous lymph nodes up to 3 cm in diameter in this region . while leucocytosis improved , there was no improvement in the lesions or crp levels , so a punch biopsy was taken from the lesions . it was considered to be cutaneous metastasis of bladder carcinoma and chemotherapy with carboplatin and gemcitabine was started . a  perivesical adipose tissue invasion and vascular invasion in cystectomy material ; b  solid tumor areas within the epidermis ; c  ck 7 positivity , d  ck 20 positivity erythematous papular lesions in the suprapubic region histopathological examination revealed a high grade ( grade 3 ) invasive urothelial carcinoma ( pt4anxm0 ) . surrounding the tumor , there was diffuse vascular embolus and perineural invasion ( fig . distant metastases were not noted in abdominal mri and thorax ct . in the first postoperative month erythematous papular lesions developed in the suprapubic region . 2 ) . physical examination revealed edema and clinically there was pain and leucocytosis and high levels of c reactive protein ( crp ) were found in the peripheral blood . it revealed cutaneous and subcutaneous edema and there were numerous lymph nodes up to 3 cm in diameter in this region . while leucocytosis improved , there was no improvement in the lesions or crp levels , so a punch biopsy was taken from the lesions . it was considered to be cutaneous metastasis of bladder carcinoma and chemotherapy with carboplatin and gemcitabine was started . a  perivesical adipose tissue invasion and vascular invasion in cystectomy material ; b  solid tumor areas within the epidermis ; c  ck 7 positivity , d  ck 20 positivity erythematous papular lesions in the suprapubic region cutaneous metastasis can be the first finding of bladder carcinoma and clinically it can be confused with cellulitis . also in our case , antibiotic treatment was primarily administered because of the picture of cellulitis and when a complete response could not be obtained skin biopsy was performed , revealing metastasis . immunohistochemically positive cytokeratin expressed from the uroepithelial tissue in skin biopsy can be useful in differential diagnosis . more than 90% of bladder carcinoma cases with cutaneous metastasis consist of transitional cell histopathology there are options of radiotherapy and chemotherapy for cutaneous metastases [ 3 , 8 ] . despite treatment , cutaneous metastasis of bladder carcinoma is an indicator of poor prognosis ; median disease - specific survival is less than 6 months [ 3 , 8 ] . in conclusion , it should be kept in mind that erythematous lesions in the suprapubic region can belong to the cutaneous metastasis of bladder cancer in particular . skin biopsy should be performed for differential diagnosis and chemotherapy should be started considering that these patients have a poor prognosis if metastasis is found .
cutaneous metastases of bladder carcinoma are very rare . 
 the rate of cutaneous metastasis in urologic malignancies is 1.3% and this rate was found to be 0.84% for bladder carcinomas . 
 cutaneous metastasis of bladder carcinoma can be confused with cellulitis . 
 this case report presents a 60-year - old patient operated on for bladder carcinoma and undergoing treatment for cellulitis because of erythematous lesions appearing in the suprapubic region in the early postoperative period . 
 as there was no response to antibiotic treatment , skin biopsy was performed and cutaneous metastasis was diagnosed . 
 subsequently , chemotherapy with carboplatin and gemcitabine was started . 
 the prognosis of bladder carcinoma with cutaneous metastasis has been reported to be poor .