Introduction: Bladder cancer is a common malignancy but presentation with metastatic disease is rare. This is the fi rst reported case of duodenal obstruction as a presentation of metastatic bladder cancer.
Clinical picture: A middle-aged woman presented with nausea, vomiting, weight loss and intermittent haematuria. Radiology and histology confirmed metastatic bladder cancer to the retroperitoneum encasing the duodenum and causing obstruction.
Treatment: Insertion of a duodenal stent relieved the obstruction and palliative chemoradiotherapy was initiated.
Outcome: The patient died 15 months after diagnosis.
Conclusions: Clinicians and radiologists should be aware of atypical presentations of common malignancies.