M.S/Glyn./Male presented with dull acliing pain in right loin. His AXR revealed a stone in right renal region and his USG showed mild hydronephrotic changes. With a provisional diagnosis of urolithiasis, IVU was advised. IVU showed scalloping of calyces due to some external compression which prompted us to consider it as a paropelvic cyst or mass. CT demonstrated a solid SOL occupying the whole renal pelvis. We did a radical nephro-urectomy with bladder-cuff with clinico-radiological diagnosis if Transitional-cell-carcinoma of renal pelvis. Histology surprised us as it was Renal cell Carcinoma!

Patient underwent a surgery of greater magnitude when lower incision and removal of distal ureter with bladder-cuff was unnecessary. Rectrospectively we realise that we should have given more importance to absence of haematuria.