Cardiac metastases of urothelial carcinoma are a rare manifestation, and most of them are asymptomatic or autoptic findings. We report a case of a 64-year-old Caucasian man fully asymptomatic, who has been accidentally diagnosed with a right atrial mass during his routine follow up for previous urothelial cancer. Endomyocardial biopsy, and histological examination of the mass were crucial to reach a definitive diagnosis of urothelial metastasis. He underwent a debulking surgery of the mass to avoid cardiac life-threatening complications. Despite effective removal of the atrial metastasis, after 45 days the patient experienced an ultra-rapid regrowth of the mass in the same position. This case demonstrates how rapidly a urothelial cardiac metastasis can grow back, and that surgery does not avoid by itself early recurrence.

尿路上皮癌的心脏转移是一种罕见的表现，其中大多数是无症状或自检结果。我们报告了一例完全无症状的 64 岁白人男性病例，他在之前尿路上皮癌的常规随访中被意外诊断为右心房肿块。心内膜心肌活检和肿块的组织学检查对于确定尿路上皮转移至关重要。他接受了肿块的减瘤手术，以避免危及心脏生命的并发症。尽管有效去除了心房转移瘤，但在 45 天后，患者在同一位置经历了肿块的超快速再生。该病例表明，尿路上皮心脏转移瘤生长的速度有多快，而且手术本身并不能避免早期复发。