“…Clinical occurrence of large and symptomatic renal leiomyoma occurs in only 4.2% to 5.2% cases as described in various autopsy series [3]. They may be located in the capsule [6], confined to the capsule alone (as seen in our case), or may extend into the parenchyma, the renal pelvis, or hilum [7,8], or may present as a suprarenal mass [9]. They are usually asymptomatic, but when symptomatic, they present with a large palpable mass (57%), pain (53%), and microscopic hematuria (20%) [3] as seen in other pediatric renal tumors such as Wilms tumor and congenital mesoblastic nephroma.…”