Spontaneous Renal Hemorrhage：An Unusual Presentation of Renal Cell Carcinoma

Spontaneous renal hemorrhage as the presenting symptom of renal cancer is rare. A 44-year-old female visited our emergency room due to sudden onset of sever right upper quadrant and right flank pain. Abdominal sonography showed a mass over the upper pole of the right kidney with heterogeneous echogenicity. Computed tomography revealed a huge hyperattenuated mass with bleeding over the right kidney. Physical examination revealed relatively low blood pressure (90/70 mmHg). Conservative treatment including a blood transfusion was done first to maintain stable vital signs. Exploratory laparotomy was done and right radical nephrectomy was performed due to renal cell carcinoma. She was regularly followed up without local recurrence for 2 years after the operation.