Cancer of the kidney is the 15th most common cancer in the world with annual incidence of 190,000 cases. Renal cell carcinoma (RCC) is the most common primary renal neoplasm in adults, and in India it forms about 1.4% of all adult malignancies. It is also referred to as ‘Hypernephroma’ or ‘Grawitz tumor’. It is more common among males and in the urban population, occurring primarily in the fifth to seventh decades of life. Though usually unilateral, it may be bilateral in 2% of cases. Familial RCC have been reported, viz Von Hippel Lindau disease, when it is often bilateral.