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Pyelocancerous backflow during retrograde pyelography is a roentgen sign indicating renal tumors. An example of a pseudotumor (renal hematoma caused by anticoagulation) is presented which displayed this type of backlfow, demonstrating the nonspecificity of the sign. The diagnostic, especially radiographic, findings of intrarenal hematoma are discussed.

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Pyelocancerous backflow is a radiologic finding strongly suggestive of renal malignancy that has had little attention in the urologic literature. Its appearance is an ominous sign and, when present, renal adenocarcinoma invading the collecting system or infiltrating transitional cell carcinoma with parenchymal extension must be suspected. An illustrative case is presented and its significance is discussed.

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