Evaluation of Recurrent Gross Hematuria in a Patient With Metastatic Prostate and Concomitant Metastatic Kidney Cancer

This is a 67-year-old man with a history of atrial fibrillation (CHADS-VASc Score of 3 on therapeutic (baseline creatine 2.2), and metastatic prostate cancer treated with androgen deprivation therapy and docetaxel as well as channel transurethral resection of the prostate for bothersome lower urinary tract symptoms. He presented with a pathologic femur fracture and biopsy demonstrated clear cell renal cell carcinoma. Computed tomography urogram demonstrated an 8-cm left inferior pole renal mass (Fig. 1). Patient subsequently developed recurrent clot hematuria despite holding his anticoagulation and intermittent improvement with bladder catheter drainage and continuous bladder irrigation.