Patient underwent right nephrectomy. Pathology revealed a collecting duct (Bellini) carcinoma.

Key points:

• collecting duct carcinoma (CDC), also known as Bellini carcinoma, is a very rare renal cell carcinoma subtype

• patients with CDC typically present with a flank mass and gross hematuria, similar to other renal malignancies

• it typically affects patients in their mid 50's. It is thought to originate in the renal medullary pyramids along the distal segment of the collecting duct

• its pattern of growth has been described as infiltrative, but are typically detected at an advanced stage and size, which makes it difficult to distinguish from other RCC subtypes