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A preterm but healthy infant was delivered and subsequently discharged from NICU. Histology revealed grade 2 bladder adenocarcinoma, in keeping with urachal origin. The patient progressed to metastatic T4 disease with pulmonary metastases and peritoneal involvement, requiring palliative chemotherapy. This case underscores the importance of a multidisciplinary approach in managing advanced bladder cancer during pregnancy, balancing maternal and foetal safety, respecting patient preferences and optimising oncological outcomes while highlighting the diagnostic and therapeutic challenges of cancer diagnosis in pregnancy.<\/jats:p>","DOI":"10.1136\/bcr-2026-275274","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:45:19Z","timestamp":1790772319000},"page":"e275274","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Metastatic muscle invasive bladder cancer in pregnancy"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0720-4281","authenticated-orcid":false,"given":"Nazneen","family":"Aslam","sequence":"first","affiliation":[{"name":"Urology, Manchester University NHS Foundation Trust, Manchester, 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