A 78-year-old man presented with fevers, cough, weakness, and diarrhea for 3 days. He had a recent hospitalization for pneumonia and acute-on-chronic renal insufficiency thought to be related to obstruction. Physical examination revealed a mildly distended abdomen with a large, nonpulsatile lower abdominal mass extending to the level of the umbilicus. Laboratory testing revealed a slight elevation in the serum creatinine level but was otherwise unremarkable. A computed tomographic scan of the abdomen and pelvis revealed a large pelvic mass with a few metallic densities about the periphery (Figure 1).