LAUSR

A 77-year-old gentleman was referred with a raised PSA (8.9 lg/L) and two episodes of painless visible haematuria. He was fit, with an ECOG performance status of 0, had never smoked, and had no occupational risk factors for bladder cancer (BC). At the time of referral, his baseline haemoglobin was 154 g/L, and he had a creatinine of 92 lmol/L and eGFR of 69 mL/min/1.73 m. A contrast computed tomography (CT) scan, arranged by his GP, identified a 5 cm solidlooking tumour on the right lateral wall of the bladder that was not causing ureteric obstruction. He was promptly referred to our haematuria service, attending 6 days after his CT scan. Flexible cystoscopy was performed with informed consent, revealing a large, solid looking bladder tumour.