What causes the Goblet sign in the ureter on imaging modalities like retrograde ureterograms? Let me know in the comments.
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The Goblet sign is caused by intraluminal masses, most commonly transitional cell carcinoma, which lead to focal ureteral dilatation. Other causes include metastatic disease, endometriosis, and sometimes blood clots or stones that have become non-obstructive over time.
Why is it called so?
It is called the Goblet sign because it resembles a goblet or champagne glass, with the dilated ureter forming the body of the glass and the narrower portion above the obstruction resembling the stem.
Pathophysiology
The sign arises due to the chronic nature of the ureteral obstruction, allowing the ureter to adapt and dilate around the mass. This gradual dilation prevents the typical spasm and narrowing seen with acute obstructions, such as those caused by ureteral stones. Ureteral dilation is a characteristic feature of intraluminal tumors and other causes of focal obstruction, leading to the appearance of the Goblet sign on imaging studies like retrograde ureterograms.
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