Table 1: Summary of cases.

Characteristic Case 1 Case 2
Histopathology of the primary tumor Non-muscle invasive urothelial cancer High grade muscle-invasive urothelial carcinoma
Treatment of primary Intravesical BCG with 3 monthly surveillance Neoadjuvant chemotherapy with cisp latin and gemcitabine followed by radical cystectomy
Any other metastasis before diagnosis of brain lesion No Lumbar spine and pelvic bones, liver
Time to brain lesion 8 years after original tumor 1 year and 10 months
Location of brain lesion Right frontal lobe Right frontal lobe
Number of lesions Solitary Solitary
Character of brain lesion on imaging Initial heterogeneous enhancing intra-axial mass with mild surrounding edema; subsequent diffuse and focal areas of dural enhancement overlying right cerebral hemisphere Bilobed enhancing lesion with restricted diffusion with mild surrounding vasogenic edema
Symptoms at presentation Left upper extremity paralysis Left upper extremity paralysis
Pathology of the brain lesion Metastatic high grade papillary carcinoma consistent with metastatic urothelial carcinoma Bacterial abscess; no neoplasm
Treatment of the initial brain lesion Right frontal craniotomy, gamma knife treatment and whole brain radiation Resection and systemic antibiotics
Clinical outcome Progression of intracranial metastases within several months Resolution of abscess, but progression of metastatic urothelial carcinoma
Recurrence of brain metastasis after initial treatment Yes Not applicable