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Bladder Cancer Haematuria — RACP Adult Medicine MCQ

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EasyNephrologyBladder Cancer HaematuriaRACP Adult Medicine

A 60-year-old man presents with painless visible haematuria. He is a smoker (30 pack-years). Urine microscopy shows non-dysmorphic (isomorphic) RBCs without casts. No proteinuria. CT urogram shows a 3 cm enhancing bladder mass. What is the most likely diagnosis?

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Correct answer: C — Bladder cancer

Painless visible haematuria with non-dysmorphic RBCs (non-glomerular source) in a smoker with a bladder mass on CT is bladder cancer (urothelial carcinoma). Smoking is the strongest risk factor. Urgent cystoscopy with biopsy/TURBT is required. All patients >40 with visible haematuria require urological investigation (CT urogram + cystoscopy) to exclude malignancy.

Reference: KHA – 2024 – Haematuria; Cancer Council 2024