29th April 2024

A 60-year-old man, a heavy smoker for 40 years, presents with a three-month history of intermittent, painless hematuria.

A 60-year-old man, a heavy smoker for 40 years, presents with a three-month history of intermittent, painless hematuria. He denies any recent history of urinary tract infections or kidney stones. His medical history is unremarkable, and he takes no regular medications. On examination, his abdomen is soft and non-tender, with no palpable masses. Urine cytology shows atypical urothelial cells.

Which is the most likely diagnosis?