We present an unusual case of renal cell carcinoma in a 59-year-old Saudi male less than 3 cm in size showing a pelvicalyceal filling defect on excretory urography and retrograde pyelography. Renal stones and blood clots were excluded by ultrasound and computerized tomography scanning. A urothelial tumor was initially diagnosed; finally surgery revealed a papillary renal cell carcinoma.
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