Abstract
Clear cell renal cell carcinoma (ccRCC) is known to display synchronous and metachronous metastases to a diverse set of organs. Retrograde and contralateral metastases of ccRCC are rare, with few cases in the literature. The mechanism of spread in these cases is thought to be facilitated by either the direct extension of tumor into the renal and gonadal veins or by the vertebral venous plexus. Here, we present a rare case of contralateral and retrograde ccRCC metastasis with extensive venous involvement.