Ureteric transitional cell carcinoma: goblet sign

Case contributed by Mohammed Al Khader.O.Thabet


Right flank pain and renal impairment

Patient Data

Age: 70 years
Gender: Male

Retrograde pyelogram was performed after an 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.

Case Discussion

The goblet sign is a 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 edema. 

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