A 39-year-old woman of Somali origin presented with periumbilical abdominal pain radiating to the back, suprapubic pain, and gross hematuria. The patient reported experiencing intermittent abdominal pain and hematuria for several months. Her medical history was remarkable for gastroesophageal reflux disease and a prior spontaneous abortion. She had no surgical history. Laboratory tests, including complete blood count, basic metabolic panel, and liver function tests, were within normal limits. A urinary pregnancy test yielded negative results. Pathologic Evaluation Cystoscopy was performed, demonstrating a large mass along the posterior and inferior walls of the bladder, with some extension along the left lateral wall. Approximately 2 hours of transurethral tumor resection was performed. Throughout the procedure, the ureteral orifices could not be identified. Subsequent photomicroscopy showed muscle-invasive squamous cell carcinoma and parasitic ova consistent with schistosomiasis. Editor's Note.-RadioGraphics continues to publish radiologic-pathologic case material selected from the American Institute for Radiologic Pathology (AIRP) "best case" presentations. The AIRP conducts a 4-week Radiologic Pathology Correlation Course, which is offered five times per year. On the penultimate day of the course, the best case presentation is held at the American Film Institute Silver Theater and Cultural Center in Silver Spring, Md. The AIRP faculty identifies the best cases, from each organ system, brought by the resident attendees. One or more of the best cases from each of the five courses are then solicited for publication in RadioGraphics. These cases emphasize the importance of radiologic-pathologic correlation in the imaging evaluation and diagnosis of diseases encountered at the institute and its predecessor, the Armed Forces Institute of Pathology (AFIP).