Reported is the case of a 72 year-old man who was hospitalized because of abdominal pain and gross hematuria. A subsequent laboratory examinations revealed a high level of serum CA 19-9, and abdominal computed tomography showed a mass lesion behind the urinary bladder and multiple lymphadenopathy. Examination of the digestive organs revealed no abnormality, however cystoscopy showed a submucosal a tumor with a partly ruddy surface. Thus, a percutaneous needle biopsy and a transurethral biopsy were performed. The pathological findings indicated a transitional cell carcinoma of the urinary bladder, and ABC-peroxidase staining revealed the presence of CA 19-9 positive cells in a portion of the carcinomatous cells.