Hematogenous metastasis to skeletal muscle from urothelial carcinoma is extremely rare and metastatic disease to skeletal muscle tends to be found in people with advanced–stage neoplasm.

In this paper we report a case of right rectus abdominis muscle metastasis from urothelial cell carcinoma. A left nephroureterectomy with bladder cuff excision was performed and revealed a high grade papillary urothelial carcinoma of the ureter. One year later, the abdominopelvic CT examination revealed a tumor mass in the anterior abdominal wall muscles with prevezical extension. Over the following months was observed increase in size of the metastases, although the patient was undergoing chemotherapy and radiotherapy. Surgery was performed for the resection of the mass in the anterior abdominal wall, with consecutive histopathological examination which revealed infiltrate of high grade urothelial. After 3 months were identified new metastases in the soft tissue and muscles.