Case Presentation: A 64 yr old gentleman presented to the emergency department of our hospital with abdominal pain and hematuria. Initial laboratory evaluation revealed unremarkable metabolic profile and mild anemia (Hgb -9.3 g/dl). Urinalysis was full of RBC’s with negative culture. CT abdomen revealed bilateral hydroureteronephrosis (HDUN) with a bladder mass (Fig I). Cystoscopy revealed [...]