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Spontaneous renal rupture is an infrequent event and is usually caused by a predisposing factor. Up to 178 cases have been published. We present a case of a large spontaneous perirenal hematoma caused by a perihilar renal cell carcinoma of a 1-cm diameter. Reviewing the literature, a classification of the condition is given according to the underlying pathology and mechanism of rupture. The need for explorative surgery in cases which cannot be clarified by noninvasive diagnostic tools is discussed.
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