A 52-year-old woman with arterial hypertension as the only history of interest. She consulted the gynaecology department for metrorrhagia accompanied by abdominal pain. She did not report haematuria or renal pit pain. Vaginal ultrasound was performed, which showed a left adnexal mass 7 cm in diameter and very vascularised, with a large uterus and normal right ovary. With the suspicion of primary ovarian carcinoma, the staging study was completed with an abdominal-pelvic CT scan, which identified a complex mass in the lower pole of the right kidney, 64 x 65 mm in diameter, with intense contrast uptake and central hypodense areas. Two other small nodules measuring 17 and 10 mm were also reported in the upper pole of the same kidney with similar characteristics to the previous lesions. The left adnexa presented a solid-cystic lesion measuring 90 x 65 mm, with intense contrast uptake. No regional adenopathy or peritoneal metastatic implants were observed.

With the diagnostic suspicion of primary ovarian carcinoma and secondary renal metastasis, total hysterectomy and double adnexectomy were performed, and radical right nephrectomy was performed in the same surgical act. The intraoperative histological study of the ovarian structure was reported as metastasis of renal cell carcinoma in the ovary. The definitive renal histological diagnosis was Fuhrman grade I renal cell carcinoma extending to perirenal fat, without infiltrating the renal vein.

