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Transitional cell carcinoma (TCC) accounts for up to 10% of neoplasms of the upper urinary tract and usually manifests as hematuria. Imaging plays an important role in assessment of upper tract disease, unlike in bladder TCC, diagnosis of which is usually made at cystoscopy. Traditional imaging modalities, such as excretory urography, retrograde pyelography, and ultrasonography, still play pivotal roles in diagnosis of upper tract TCC, in combination with endourologic techniques. The multicentric nature of TCC makes assessment of the entire urothelium essential before treatment. The advent of minimally invasive surgery, which allows renal preservation in selected patients, makes accurate tumor staging mandatory to determine the appropriate therapy; staging is usually performed with computed tomography (CT) or magnetic resonance (MR) imaging. Vigilant urologic and radiologic follow-up is warranted to assess for metachronous lesions and recurrence. The emerging technique of CT urography allows detection of urinary tract tumors and calculi, assessment of perirenal tissues, and staging of lesions; it may offer the opportunity for one-stop evaluation in the initial assessment of hematuria and in follow-up of TCC. Similar MR imaging protocols can be used in patients who are not candidates for CT urography, although detection of urinary tract calcifications may be suboptimal.

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We report the case of a 39-year-old asymptomatic woman who presented for screening mammography. Mammography revealed a round, partially circumscribed, partially indistinct, noncalcified 4.5 cm mass in upper outer right breast. This vaguely palpable mass appeared as a well-circumscribed, oval, hyperechoic, parallel, septated mass on sonography. Ultrasound-guided core biopsy led to the diagnosis of hibernoma. Few cases of hibernomas have been reported in the English literature, and their occurrence in the breast is particularly rare [Eur J Surg Oncol 26 (2000) 430; Am J Surg Pathol 25 (2001) 809]. To our knowledge, this is the first case of mammary hibernoma in which the ultrasonographic and mammographic features of this unusual entity are demonstrated.

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