A 70-year-old man with a history of hypertension and asymptomatic atrial flutter presented with pyuria on urine microscopic examination. Cystoscopy revealed bladder lesions emanating from the left ureteral orifice and posterior lateral wall (Figure, A and B). Upper tract evaluation with ureteropyelograms revealed no other lesions. Transurethral resection of the bladder tumors was performed to further characterize these lesions. Histopathological examination revealed the presence of noninvasive high-grade urothelial carcinoma (Figure, C and D).