Upper Tract Urothelial Carcinoma with Intra-renal Haemorrhage

A 60-year-old man with right upper tract urothelial carcinoma (UTUC) developed sudden onset right upper abdominal pain. He had no haematuria, nausea or vomiting and examination revealed right upper abdominal tenderness. Laboratory investigations showed drop-in haemoglobin. Computerised tomography revealed hyperdense contents within the renal pelvis extending into the renal parenchyma. After anaemia correction, radical nephroureterectomy confirmed the intra-renal haemorrhage. At 12 months follow-up, the patient is asymptomatic and recurrence-free. Only a few reported cases of perirenal haemorrhage are available in the literature. However, there is no report on intra-renal haemorrhage in UTUC. We present the first case of intra-renal haemorrhage (IRH) in UTUC managed with radical nephroureterectomy.