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Renal cell carcinoma (RCC) represents 2-3% of all malignancies. It is the commonest solid lesion of the kidney and accounts for 90% of all kidney malignancies. Even though RCC classically presents as a triad of flank pain, haematuria and palpable mass, with the availability and common use of imaging techniques, more than 50% are diagnosed incidentally. Nephron sparing surgery in the form of partial nephrectomy is recommended for early renal tumours to avoid long term renal insufficiency. Rarely RCC presents as a spontaneous renal haematoma (SRH) in subcapsular or peri-renal spaces which are known as Wunderlich syndrome [1]. In such situations whether nephron-sparing surgery is an oncologically adequate option is unknown.

Rapid development of recurrences after partial nephrectomy for papillary renal cell carcinoma initially presented as Wunderlich syndrome