Renal Medullary Carcinoma: A Call for Screening and Early Diagnosis.

Renal medullary carcinoma (RMC) is a highly aggressive malignancy associated strongly with sickle cell trait (SCT). This primarily affects young individuals, often presenting with nonspecific symptoms that cause delayed diagnosis, such as hematuria, flank pain, and weight loss, leading to a poor prognosis. We describe the case of a young adult man with no significant past medical history who presented to the emergency department with sudden-onset abdominal pain. Initial workup revealed mild anemia and microscopic hematuria. Contrast-enhanced computed tomography identified a right renal mass and retroperitoneal lymphadenopathy suggestive of metastatic disease. Renal biopsy confirmed RMC. Due to the advanced stage of disease and limited treatment options, the patient and his family opted for palliative care. He passed away at home several weeks later under hospice services. This case highlights the importance of considering RMC in young patients with SCT who present with unexplained abdominal pain and hematuria. Early recognition, multidisciplinary evaluation, and emphasis on supportive care are critical components in the management of this rare and aggressive malignancy.