Double trouble: A novel case report of synchronous bilateral renal cell carcinoma of differing histology

Renal cell carcinomas account for 2-3 % of all malignancies. In non-familial syndrome patients, another kidney tumor synchronous, antecedent, or subsequent to diagnosis of RCC is relatively rare. It is very rare for the kidney tumor to be malignant and of differing pathology altogether. We herein describe a 67-year old male with bilateral synchronous masses treated with open bilateral adrenal sparing radical nephrectomy. His final pathology was interestingly found to have novel, differing aggressive cancers: a TFE3-rearranged RCC and a grade 4 WHO clear cell RCC.