The majority of ureteropelvic metastatic tumors are of non-urologic origin. A case of metastatic clear cell adenocarcinoma to the renal pelvis in a patient with a bilateral, asynchronous renal tumor is presented. Conservative surgical treatment involved open pyelotomy and local resection of the tumor. At the 12-month follow-up, the patient is alive, asymptomatic and not on dialysis. The hypothesis for the mechanisms of dissemination and the relevance of conservative treatment are discussed.
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