Primary Mid-ureter Squamous Cell Carcinoma: A Diagnostic Conundrum in the Absence of Traditional Risk Factors

Primary squamous cell carcinoma (SCC) of the ureter is an exceedingly rare entity, accounting for only 1-1.6% of upper urinary tract tumors. It is typically associated with chronic irritation, infection, or urolithiasis and often presents at an advanced stage with a dismal prognosis. We report the case of an 81-year-old male presenting with right flank pain and radiological evidence of hydronephrosis. Imaging identified a mid-ureteric mass without distant metastasis. The patient underwent robot-assisted laparoscopic nephro-ureterectomy with pelvic lymph node dissection, achieving negative surgical margins. Histopathology confirmed moderately differentiated SCC staged as pT3N0R0V0. This case highlights the diagnostic challenge of ureteric SCC in the absence of traditional risk factors and suggests that surgical resection alone may achieve favorable short-term outcomes in select patients.