67 year old man had painless haematuria. Physical examination revealed a unilateral ballotable kidney.
The proximal third of the ureter shows thickening of the wall and obliteration of the lumen by a pale circumferential growth with a papillary configuration. This extends proximally to the pelvi-ureteric junction. In the kidney, there is gross dilatation of the pelvicalyceal system with marked thinning of the renal parenchyma. At the top part of the specimen, a discontinuous focus of tumour is seen within a dilated calyx.