Urinary tract malignancies (primarily renal cell carcinoma and adenocarcinoma of the bladder) are common. In the United States, bladder cancer is the fifth most common cancer, accounting for 4.5% of new cases.1,2 Risk factors include increasing age, white race, and history of smoking.2 Hematuria is the clinical presentation of 90% of cases of bladder cancer, although most cases of hematuria are unrelated to malignancy.2 One retrospective study found urinary tract tumors in 10% of patients presenting with gross hematuria and 3% of patients presenting with microhematuria.3