Introduction Most common cancer of the bladder most commonly in lateral or posterior walls of bladder base can also occur in renal calyces, renal pelvis, and ureters usually a multifocal disease with papillary histology Risk factors phenacetin smoking aniline dyes cyclophosphamide beer consumption (nitrosamines) Schistosoma hematobium more commonly produce squamous cell carcinoma but can also produce TCC Presentation Symptoms hematuria/dysuria Differential Urethral cancer if blood is present with urethral discharge think urethral cancer Evaluation Intravenous pyelography (IVP) and cystoscopy Alternative modalities include ultrasonography and CT scan CT urography is a relatively new technique producing images similar to IVP while also giving traditional CT images. Prognosis Improved prognosis with blood group antigen expression of the tumor