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Received January 2010 Accepted February 2010 INTRODUCTION Renal cell carcinoma (RCC) classically presents as a triad of hematuria, loin pain, and a palpable mass. However, RCCs are increasingly found as incidental findings on the radiological imaging ordered for other reasons.(1) The spontaneous rupture of the kidney, or Wunderlich syndrome, is very rarely the first presentation of RCC. We describe a clinical case of spontaneous renal hemorrhage as the first manifestation of RCC that was treated with therapeutic embolization and early radical nephrectomy.

Wunderlich syndrome as the first manifestation of renal cell carcinoma.