Bladder cancer lymph rarely presents with neck metastasis. The main metastatic pathways of bladder cancer are lymphatic metastasis, hematogenous metastasis and implantation metastasis. The main sites of lymphatic metastasis are regional lymph nodes, such as closed foramen ovale lymph nodes, internal iliac lymph nodes, etc. Further metastasis can be to para-aortic lymph nodes and para vena cava lymph nodes. Hematogenous metastasis often metastasizes to organs such as lung, liver, bone, brain, etc. If the tumor breaks through the bladder wall from the top of the bladder, abdominal implantation metastasis can occur, which metastasizes to the greater omentum, intestines, ovaries and other places. However, bladder cancer seldom shows neck lymph node metastasis. If bladder cancer patients find abnormalities in the neck during examination, they need to go to regular hospitals, further improve the examination, such as CT and pathological biopsy, to clarify the diagnosis and receive appropriate treatment.