Abstract
Incidental Renal Cell Carcinoma (RCC) can be found in a tubercular kidney; however, the vice versa i.e., finding tubercular lymphadenopathy after radical nephrectomy for cancer is exceptionally rare. To the best of our knowledge, only two cases of coexistent renal cell carcinoma and tubercular paraaortic lymphadenopathy have been reported till date. Out of these, only one case was of papillary renal cell carcinoma. We hereby, report a rare case of papillary renal cell carcinoma with coexisting paraaortic tubercular lymphadenopathy, which was upstaged based on radiology findings. This case highlights the importance of considering the possibility of tuberculosis in cancer-associated lymphadenopathy. This can prevent unnecessary lymphnode dissection and inappropriate clinical upstaging in renal cancer patients.