Synovial sarcomas (SS) account for 5-10% of all soft tissue sarcomas. They usually occur between the third and fifth decades of life. In 65% of cases, they are located in the lower extremities, with the most common location being around the knee. Unusual areas of formation include the head, neck, heart, lungs, and kidneys. 1, 2 imary renal SS are very rare and highly aggressive tumors with the common symptoms of side pain, abdominal pain, and hematuria. Low back pain, back pain, palpable mass,

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... ever, and hypertension can also be seen, albeit rarely. 3 In the literature, only one case with renal rupture and spontaneous retroperitoneal hemorrhage was previously reported. 4 To our knowledge, ours is the second case with a similar clinical presentation. In this case report, we aimed to draw attention to a condition that is often overlooked in retroperi-toneal hemorrhage and evaluate renal SS in the light of literature. CASE REPORT A 37-year-old male patient presented to the emergency department with left side pain, hematuria, fever and fatigue. There was no history of trauma. The results of his laboratory test were as follows: white blood cell count 21.7 10 3 /uL, hemoglobin 11.27 g/dL, hematocrit 34.11, platelets 267.7 10 3 /uL, urea 57 mg/dL, and C-creatinine: 2.9 mg/day dL. Due to the elevated creatinine levels, non-contrast abdominopelvic computed tomography was performed, which revealed a hematoma filling the retroperitoneum around the left kidney (Figure 1 ). The patient was admitted to hospital with the diagnosis of spontaneous massive retroperitoneal bleeding. Hemodynamic monitoring was provided. During the follow-up, he-