Presentation
Hematuria.
Patient Data
Well defined enhancing 7.5 x 3 cm mass involving the posterior aspect of the urinary bladder extending from the base to the dome. The mass extends beyond the bladder serosa and displaces and invades the anterolateral aspect of the right side of the uterus.
The mass obstructs and extends 2 cm into the distal right ureter with a resultant severe right hydronephrosis. Delayed right sided nephrogram.
Small simple cysts in the liver. The remainder of the upper abdomen is normal.
No para-aortic or pelvic lymphadenopathy.
Case Discussion
This is an example of an advanced case of transitional carcinoma of the bladder with ureteric and uterine invasion. A radiological T-stage of 4a.