Ureteric transitional cell carcinoma: goblet sign
Right flank pain and renal impairment
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Retrograde pyelogram was performed after unenhanced KUB CT scan shows large filling at the mid/lower third junction of right ureter causing dilated ureter above and below the site of obstruction, the dilatation below the obstruction is cup shaped appearance consistent with goblet sign.
The goblet sign is highly characteristic sign of TCC (in this case of biopsy proven TCC) with distal and proximal ureteric dilatation due to slow growth. A stone filling defect will cause upstream dilatation usually and downstream narrowing due to spasm and oedema.