Urothelial neoplasm in a 19-year-old male patient with urine discoloration, negative lab, and imaging workup: Should we investigate the findings or the symptom?

With few cases of PUNLMPs in young adults being reported in the literature, we hope to raise clinical awareness of prompt and effective diagnosis, while maintaining a high index of suspicion among health professionals. Even in the absence of red blood cells in the urine and subsequent negative imaging workup, clinicians should not delay performance of diagnostic cystoscopy.