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This case presents a patient with a remote history of complex posterior urethral repair related to a prior motorcycle accident who presented to the urology clinic in urinary retention with associated lower urinary tract symptoms. Due to his altered anatomy, traditional outlet procedures were deferred due to significant reported risks of post treatment urinary incontinence. Decision was made to proceed with prostatic artery embolization, and at follow up he reported resolution of his urinary retention and significant symptomatic improvement in his voiding without development of urinary incontinence.

Renal cell carcinoma (RCC) classically metastasizes to the lungs, bones, adrenals, lymph nodes, liver, and brain. RCC metastasis to the gallbladder is rare occurring in less than 1% of metastases. We present a case of a 60-year-old male who at initial diagnosis of his large left renal mass was incidentally found to have a gallbladder mass. He underwent simultaneous open radical nephrectomy and cholecystectomy with pathology confirming solitary metastatic clear cell RCC (ccRCC). The patient chose surveillance and was without evidence of disease for three years. At three years, imaging showed a 2 cm contralateral renal mass which was cryoablated percutaneously. This case demonstrates not only the importance of a thorough review of initial and surveillance imaging but also of maintaining a broad differential for other solid organ masses in the setting of a primary RCC of the kidney.