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Acute Mediastinal Enlargement

Harold Simon, M.D.; William T. McCoy, M.B., B.S.
JAMA. 1961;178(3):318-319. doi:10.1001/jama.1961.73040420018012.
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Dr. John B. Little: A 72-year-old man was admitted with dysuria of approximately 4 weeks' duration. This had occurred sporadically throughout this 4-week period, but it occurred every day in the 2 or 3 days prior to admission. It was associated with burning, but little else; the burning was noted to occur throughout voiding.

Shortly after admission an intravenous pyelogram was obtained. The interpretation was as follows: "Both kidneys function normally. There appears to be a soft tissue mass adjacent to the lower pole of the left kidney. In addition, there is marked trabeculation of the bladder with diverticula and a filling defect on the right lateral aspect of the bladder." At cystoscopy a 1-2 cm. mass was noted on the right side of the bladder. Biopsy showed this to be carcinoma. With this in mind, a chest film and metastatic series was performed and reported as follows: "There is


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