DISCUSSION: RMC is a rare disease that predominantly affects young patients with sickle cell trait with a prevalence of 1 in 20,000. Men are preferentially affected in a 2:1 ratio and the median age at diagnosis is 22. It is hypothesized that areas of vaso-occlusion and chronic ischemic changes leads to damage in the renal medulla, explaining the increased pathogenesis in patients with sickle trait. Symptoms at presentation are usually flank pain, abdominal pain and hematuria, and respiratory symptoms only accounted for 9% of cases in a review. Metastasis is common on presentation with common sites including lymph nodes, liver, lung, and adrenal glands. Tumors are detected using ultrasound, CT and MRI. A variety of cytotoxic chemotherapy as well as targeted therapy is currently used. There is no standardized treatment for RMC, and radiation and chemotherapy have not proven to significantly improve outcomes. Prognosis is poor with 95% mortality from disease progression and a median survival time of 1 year after diagnosis.