Renal calyceal rupture with extensive urinoma formation as a complication of cervical cancer

Renal calyceal rupture (RCR) is a rare phenomenon most commonly caused by increased renal pelvic pressure from ureteral obstruction. This can occur in the setting of acute obstruction such as with kidney stones and is not commonly seen as a consequence of malignancy due to the chronic nature of obstruction. In this case, we describe a patient with newly diagnosed cervical cancer presenting with thigh pain who was found to have a urinoma from RCR caused by malignant obstruction. We discuss the workup of a pelvic mass presenting as flank pain, as well as the role of history and physical exam when reviewing imaging. We also review the management of RCR in the setting of malignant obstruction. Lastly we highlight the alterations to cervical cancer treatment due to the presence of the infected urinoma.