Introduction: Renal cell carcinoma (RCC) usually presents with the classic three signs: flank pain, blood in the urine, and a palpable mass in the abdomen. Presentation of case: We present a case of a 54-year-old woman who exhibited altered bowel habits. Cholecystectomy was scheduled after the identification of gallstones; however, a preoperative CT scan inadvertently disclosed RCC. The tumor affected the renal vein and extended into the ureter. The patient underwent a radical nephrectomy, during which the renal vessels were tied off with Vicryl sutures, and the ureter was cut up to the vesicoureteral junction. Clinical discussion: To our knowledge, this constitutes an uncommon incidental discovery of clear cell carcinoma in a patient lacking typical RCC symptoms, demonstrating intraluminal extension into the ureter. This pattern of dissemination is not delineated in the current literature, nor is it referenced by the existing AJCC staging system. Conclusion: This case may indicate the necessity for reevaluation or alteration of the AJCC guidelines to accommodate intraluminal ureteric extension in clear cell RCC.