Explanation:
Renal papillary hypertrophy is a rare variation that mimics UTUC. This is the ninth case in the literature. It causes hematuria and pain, or it could be asymptomatic. It’s important to distinguish this variation from malignant masses since misdiagnosis leads to unnecessary radical surgery. F-URS helps distinguish malignant from benign masses, particularly in cases where there is no consensus on the exact pathology of the mass. We present a 46-year-old female who came with hematuria and was planned to undergo RNU under the impression of RCC based on imaging studies. After f-URS, renal papillary hypertrophy was confirmed, and RNU was prevented.