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A 55-years-old man presented with the chief complaint of right flank mass and hematuria. CT scan revealed clinical T4 RCC. Cytoreductive nephrectomy (CN) was performed with histopathology result of Papillary renal cell carcinoma. A month later, the patient was admitted to the emergency room with severe dyspnea suggesting intrapulmonary metastases. Here we present an unusual case with a new pulmonary metastasis lesion rapidly appear a month after cytoreductive nephrectomy.