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+A 67-year-old man with a history of hypertension and hiatal hernia under medical treatment came to the urology department for monosymptomatic and self-limiting haematuria.
+Physical examination revealed no findings of interest.
+Blood tests showed that all parameters were within normal limits.
+Intravenous urography showed a repletion defect in the right renal pelvis, which was later confirmed by abdominal computed tomography showing a mass in the pelvis amputating the middle calyx.
+Cytology was negative.
+Right nephroureterectomy was performed. Endoscopic ureteral deinsertion was first performed with the technical modification described below, followed by nephroureterectomy through a right subcostal incision.
+The macroscopic description of the specimen shows a vegetative, exophytic and papillary lesion that occupies the middle calyx and part of the renal pelvis without infiltrating parenchyma.
+Microscopically, the tumour was reported as a high-grade urothelial carcinoma that did not invade the lamina propria (Ta G3).
+After four years of follow-up the patient is alive and free of disease.
+
+