Metastatic urothelial carcinoma of the bladder with sarcomatoid differentiation showing large cell neuroendocrine transformation in the liver; an unusual behaviour of a rare disease

Metastatic urothelial carcinoma of the bladder is generally considered to be an aggressive disease with many recognised variants, however what is unique about our patient is the metastatic transformation from a urothelial primary malignancy with sarcomatoid variation to a neuroendocrine deposit within the liver. From what we have identified, this pattern of pathological transformation has not been reported for a urothelial malignancy in the literature. We present a 64 year old male who we believe is the first reported case of a primary urothelial malignancy presenting de-novo with metastatic liver deposits showing neuro-endocrine transformation.