​Bilateral renal cell carcinoma (RCC), is a rare clinical condition having a reported incidence of 0.4-5% ¹. It may be synchronous (coexisting at the time of initial diagnosis) or metachronous (developing subsequently) ¹. The risk of developing subsequent contralateral RCC (metachronous) is roughly 10 times higher after the initial detection of RCC. Black race, male gender, younger age, and papillary histopathology are the peculiar predisposing factors for a metachronous contralateral RCC ¹. The risk of metachronous RCC is also higher in the patients with positive family history of RCC or patients with history of Von Hippel-Lindau disease ¹. Some authors use 6 months cutoff to define metachronous disease whereas others use one year ¹. In our case, the time interval between the detection of right and left renal lesions was 7 months. 

After the first postoperative ultrasound examination, the patient missed her regular follow-up visits and returned to the clinic after 6 months when 2nd postoperative ultrasound, followed by the contrast enhanced CT scan were performed. Later on, the patient underwent left partial nephrectomy.