More than 15 thousand new cases of renal cell carcinoma are registered annually in the world. This is 3% in the structure of the general oncological morbidity of the population and leads it to the third place among oncourological pathologies. The introduction and development of new targeted and immunotherapy drugs does not yet provide a lasting effect in disseminated forms of the disease. This approach is not justified in its localized versions. Early detection and surgical treatment are the only effective ways to save patients' lives and give a chance for long-term control of the tumor. Nephron-saving treatment of patients with renal cell carcinoma only a single kidney or only a single functioning kidney provides a high quality of life and reduces the risk of systemic progression compared with various options for renal replacement therapy.

The article shows the clinical observation of early recurrence and progression of renal cell carcinoma in a patient with intermediate risk and idiopathic rupture only functioning kidney. At the stages of treatment, it was difficult to determine the cause of this rapid progression of renal cell carcinoma. Performing a transplantectomy and removing the implantation metastasis did not achieve the desired result. The patient died from complications of renal replacement therapy against the background of concomitant extrarenal pathology.

The relationship between kidney damage and the likelihood of progression of renal cell carcinoma and the choice of tactics in these patients require further study. This clinical observation once again points to the tendency of renal cell carcinoma to implantation metastasis. In such cases, there is a higher rate of progression than with a local recurrence of the primary tumor. This is one of the reasons for our refusal to perform biopsy in kidney tumors.

Authors declare lack of the possible conflicts of interests.