Thermal ablation for renal cell carcinoma in nephron-sparing surgery has been extensively investigated. However, data regarding renal pelvic tumors with refractory hematuria are scarce. Herein, we report a case of recurrent hematuria in an 87-year-old woman with. a 3.5 × 4.1 cm mass in the right renal pelvis on imaging examinations, which was clinically diagnosed as renal pelvic carcinoma. After ineffective renal artery embolization, minimally invasive percutaneous thermal ablation was recommended after a multidisciplinary consultation. Although hematuria was successfully relieved after ultrasound-guided radiofrequency ablation initially, recurrence of hematuria was reported due to tumor progression after one year. CT-guided microwave ablation resolved hematuria and controlled tumor growth without complications. Upper tract urothelial carcinoma (UTUC) was confirmed by biopsy. Postoperative CT imaging, urine cytology, and renal function tests were continuously monitored during the follow-up. The patient remained stable during the 1-year follow-up period, highlighting the potential of thermal ablation for refractory hematuria in renal pelvis urothelial carcinoma while preserving nephrons.
