• Ga Yang Shim, Min-Su Kim, Hong Jun Kim, Yewan Park, So-Woon Kim, and Myung Chul Yoo.
• Department of Physical and Rehabilitation Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.
• Medicine (Baltimore). 2024 Mar 29; 103 (13): e37639e37639.

RationaleRenal cell carcinoma (RCC) is the most common renal neoplasm, accounting for 2.4% of all cancers in Korea. Although the usual clinical manifestations of RCC include flank pain, hematuria, and palpable mass, RCC is generally characterized by a lack of early warning signs and is mostly discovered incidentally in advanced stage. This case report describes a 42-year-old Korean man diagnosed with giant RCC who presented with simple back pain.Patient ConcernsThe clinical manifestation of a 42-year-old Korean man was chronic back pain.DiagnosesContrast-enhanced computed tomography showed a 19.1-cm sized heterogeneous enhancing mass on the right kidney and tumor thrombosis extending into inferior vena cava.InterventionDue to the large size of the tumor and extensive tumor thrombosis, the multidisciplinary team decided to administer neoadjuvant chemotherapy and an anticoagulant. Following 12 cycles of treatment with nivolumab and cabozantinib, he underwent a right radical nephrectomy with an adrenalectomy and tumor thrombectomy.OutcomesTreatment was successful and posttreatment he started a cancer rehabilitation program. He was followed-up as an outpatient and no longer complains of back pain.LessonsRCC can manifest clinically as back pain, with diagnosis being difficult without appropriate imaging modalities. RCC should be included in the differential diagnosis of patients with low back pain, even at a young age.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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