Julia R. Fielding, M.D. Brigham and Women's Hospital, Harvard Medical School Boston, Massachusetts

Microscopic Hematuria in a Patient with a History of Transitional Cell Carcinoma

This 84 year-old man had undergone contrast-enhanced CT examination for staging of transitional cell carcinoma of the left renal collecting system prior to nephroureterectomy in 1994 (Figure 1). He presented in December 1996 with painless hematuria. A right retrograde pyelogram was performed (Figure 2).

The diagnosis is Transitional cell carcinoma in situ of the distal ureter manifested by a stricture. A few air bubbles are seen in the proximal, slightly dilated portion of the ureter. The retrocaval portion of the ureter was mobilized, the distal ureter resected and reimplantation of the ureter performed.