Transitional carcinoma of the bladder
Smoker. Anemic with hematuria. Cause?
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Irregular 4.8cm cauliflower-like mass on the left posterolateral wall of the urinary bladder. The mass covers the left ureteric orifice. No extra-serosal invasion.
The upper tracts are normal in appearance. No hydronephrosis.
Liver, spleen, pancreas, adrenals and bowel are unremarkable.
No ascites or abdomino-pelvic lymphadenopathy.
No destructive bony lesion.
An exceptionally large bladder tumor. In many instances, in the investigation of hematuria, a CT is performed prior to cystoscopy (rightly or wrongly). Rarely is such a pronounced tumor identified.
Assessment of the upper tracts is important to ensure no synchronous transitional cell carcinoma is present.