Radiological Case of the Month

Clinical History.—An 18-month-old Brazilian boy was referred to the Stanford University Hospital for identification of the stage and treatment of Hodgkin disease. As part of the roentgenographic evaluation, an intravenous urogram was performed. No urinary tract symptoms were present.

Denouement and Discussion 

Unusual Presentation of Phimosis  The five-minute roentgenogram of the patient in the supine position demonstrated a normal urinary tract (Fig 1). At ten minutes, all of the contrast material that was in the bladder on the five-minute film descended into a well-localized, smooth structure that projected below the level of the inferior pubic rami in the midline (Fig 2). A smooth filling defect was noted on the superior margin of this peculiar collection of opacified urine. This most unusual finding prompted a second physical examination of the lower abdomen and pelvis. Abdominal musculature was intact. The proximal portion of the penis and the testes was normal. There