Dr. James W. Wallace: This 65-year-old man noted intermittent, initial hematuria. He had had gout for many years. At the time of physical examination, evidence of gout was noted, and the prostate gland was moderately enlarged. The urine contained a few erythrocytes and a few leukocytes. Hemoglobin level was 15 gm/100 cc, and white blood cell count was normal.
Dr. Laurence L. Robbins: Would you discuss this case, Dr. Nebesar.Dr. Robert A. Nebesar: Several pyelograms have been done over the past six years. On the pyelogram done six years ago, the right kidney looks normal, but the left shows displacement of the upper and middle calices around a central mass (Fig 1). The ureters are normal. The filled bladder shows impression from an enlarged prostate gland.Dr. Wallace: After this first examination, prostatectomy was performed for benign hyperplasia. The most recent examination was done because of persistent left