(UroToday.com) The 2021 American Urological Association (AUA) Summer School session on Upper Tract Urothelial Carcinoma included a case-based discussion led by moderator Dr. Surena Matin who was joined by panelists Dr. Sima Porten and Dr. Vitaly Margulis. This case highlighted the management of upper tract urothelial carcinoma with node positive disease and a low eGFR. The patient was a 55-year-old male with gross hematuria and a right distal ureteral sessile tumor that was biopsied showing high-grade urothelial carcinoma. The patient received a ureteral stent and was referred to urologic oncology with an eGFR of 42. The right kidney was noted to be atrophic (4% function) with multiple (4-5) enlarged regional lymph nodes (hilar, retrocaval, interaortocaval), with a negative chest CT and no evidence of distant metastasis: