Massive intratumoral bleed in renal cell cancer: an unusual life-threatening event

Renal cell cancer (RCC) commonly presents as an asymptomatic incidental mass on imaging for other abdominal pathologies. Because of its hypervascular nature, spontaneous haemorrhage, although very rare, can be seen with RCC. Spontaneous haemorrhage may present with flank pain, fever and sudden abdominal distension with or without haemorrhagic shock. Although unusual, spontaneous haemorrhage is potentially serious, and therefore clinicians should be aware of such events. Imaging may be difficult to interpret in view of intratumoral and perinephric haemorrhage. Prompt diagnosis and treatment is essential for a successful outcome. We report a case of massive intratumoral bleed in RCC in a young male and its management by renal artery angioembolisation followed by radical nephrectomy.