A case of bladder carcinoma is presented in which active tumor bleeding was demonstrated on ultrasonography and confirmed by cystoscopy. Identical appearances were seen in an experimental model in which human blood was injected into a bag of human urine. We are not aware of previous reports on similar findings in the bladder.
CASE REPORTA 73-year-old retired analytic chemist who had spent 15 years in the dye industry was admitted to hospital with a 3-week history of painless hematuria. For several years he had been troubled by hesitancy of micturition, and for the last 5 months he had complained of nocturia, poor urinary stream, and postmicturition dribbling of urine. On examination he had an enlarged prostate, and visual inspection of his urine confirmed hematuria.An intravenous urogram showed no abnormality in the left kidney, but the right kidney was hydronephrotic and poorly functioning. Visualization of the bladder was poor, and hence ultrasound examination was performed. This was carried out with a Diasonics DRF 400 scanner using a 3.5-MHz sector probe. Ultrasonography confirmed the right hydronephrosis and showed dilatation of the right ureter. Scanning the bladder demonstrated an intraluminal mass lesion arising from the right side of the posterior wall. A second irregular mass lesion was identified at the bladder base.The most dramatic finding on ultrasonography was the presence of a continuous stream of small echoes arising from the apex of the mass on the