Solitary meningeal recurrence in a patient with transitional cell carcinoma of the bladder with locally bulky disease at presentation

Patients with locally advanced transitional cell carcinoma (TCC) of the bladder are at high risk for systemic relapse, with liver, bone and lung being the commonest sites of metastases. We report the case of a 52-year-old woman with a solitary meningeal relapse, a rare site of recurrence, after 8 months of complete remission obtained with M-VEC for locally advanced TCC of the bladder. We speculate on the likely risk factors related to this unusual site of recurrence.