腎臟腫瘤以自發性腎臟出血為臨床表徵並不常見，一位44歲女性因突發性右上腹及右腰劇痛至本院急診，經腹部超音波及腹部電腦斷層掃描，在右腎上部發現一異迴音性之腫塊，理學檢查發現血壓偏低（90/70mmHg）。病人先接受保守性治療包括輸血以穩定生命徵候，之後接受探查手術。由於冷凍病理切片為腎細胞癌，病人接受根除性右腎摘除手術。病人術後定期於門診追蹤，經二年的追蹤並無局部復發或轉移的情形。

Spontaneous renal hemorrhage as the presenting symptom of renal cancer is rare. A 44-year-old female visited our emergency room due to sudden onset of sever right upper quadrant and right flank pain. Abdominal sonography showed a mass over the upper pole of the right kidney with heterogeneous echogenicity. Computed tomography revealed a huge hyperattenuated mass with bleeding over the right kidney. Physical examination revealed relatively low blood pressure (90/70 mmHg). Conservative treatment including a blood transfusion was done first to maintain stable vital signs. Exploratory laparotomy was done and right radical nephrectomy was performed due to renal cell carcinoma. She was regularly followed up without local recurrence for 2 years after the operation.