Presentation
Weak stream and hematuria.
Patient Data
Multiple enhancing polypoid masses of various sizes arising mainly from the bladder wall (mainly from the anterior wall and bladder base) protruding into the bladder lumen and invading the ureteral orifices with bilateral ureterohydronephrosis. An extravesical extension is noted on the right posterolateral aspect of the bladder around the ureteral orifice with involvement of the seminal vesicle.
Multiple abdominal and pelvic lymphadenopathy mainly paraaortic, aortocaval and along the iliac vessels.
Small non-specific right adrenal nodule (5 mm).
Small simple hepatic cysts.
Prostatic hypertrophy (volume = 43 mL on ultrasound).
Case Discussion
CT features of multiple enhancing masses projecting into the bladder lumen with extravesical extension and multiple abdominal and pelvic lymphadenopathy, most consistent with a transitional cell carcinoma that was confirmed by cystoscopy with biopsy.
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