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.