A 60-year-old woman without any other medical problems underwent a right robotic-assisted laparoscopic partial nephrectomy for a 2.5 cm mid-right renal posterior cortical heterogeneously enhancing mass found on computed tomography (CT) scans (Figures 1 and 2). Final pathology revealed clear cell renal cell carcinoma with negative margins. She was discharged the next day after an uneventful hospital course.
Ten days later, the patient presented to the emergency department with right flank pain and hematuria with blood clots. She was hemodynamically stable, with a hematocrit of 32 (vs 40 on discharge). She had no fever, chills, or leukocytosis.