In a series of 80 consecutive cases of muscle-invasive urothelial bladder carcinomas, Jimenez and colleagues showed that 45% of Her2/neu negative primary disease had Her2/neu positive metastatic nodal disease, while only one case (8%) of Her2/neu positive primary disease manifested with Her-2/neu negative nodal metastatic disease [9]. The gene discussed is ERBB2; the disease is metastatic neoplasm.