Identifying High-Risk Upper Tract Urothelial Carcinoma

A 76-year-old man with a long-standing history of low grade urothelial carcinoma reported gross hematuria. An upper tract study in the form of a computed tomography (CT) urogram demonstrates a filling defect in the right upper pole. Cystoscopy does not show any lower track pathology; however, ureteroscopy confirms a large papillary lesion in the right upper pole calyx.