Concomitant spontaneous hemothorax and perinephric hematoma: rare presentation of Renal cell carcinoma

Spontaneous hemothorax and perinephric hematoma are rare presentations of renal cell carcinoma. We present the case of a 30-year-old female who presented with progressive fatigue and weight loss over a 2-month period. Initially, she was suspected to have empyema and received anti-tuberculosis therapy at a local hospital. However, further evaluation revealed a low hemoglobin level and a CT scan showed a right renal mass with lung metastasis, along with massive hemothorax, perinephric, and retroperitoneal hemorrhage. She underwent surgical management with radical nephrectomy and evacuation of the hematoma. Pathological examination of the surgical specimen confirmed renal cell carcinoma. After treatment, the patient was discharged in stable clinical condition.