A 59-year-old woman with no previous history of interest presented with haematuria and pain in the right renal fossa and right hypochondrium of 6 hours' duration. She was accompanied by nausea and hypotension with 90/50. Laboratory tests showed leukocytosis with neutrophilia. An abdominal ultrasound scan showed a heterogeneous image measuring 15 x 14.5 cm depending on the right kidney. Several hours later his general condition worsened, with a greater tendency to hypotension and an increase in abdominal mass. An abdominal CT scan was performed showing a large renal mass occupying the entire right hemiabdomen with the appearance of intratumoural bleeding and free intra-abdominal fluid. Surgical intervention was decided due to haemodynamic instability, and a right nephrectomy was performed. The anatomopathological study was reported as clear cell renal adenocarcinoma 10 cm in diameter in the medial area of the kidney infiltrating the renal capsule without affecting the sinus, vascular and hilar structures; stage G II, T2.

