Metastasis of renal cell carcinoma to the contralateral testis is a rare occurrence, and we reported a case. The patient had previously undergone radical left nephrectomy for clear cell carcinoma of the left kidney. Six years postoperatively, he presented with enlargement of the right testis and subsequently underwent radical orchiectomy. The postoperative pathological results confirmed the diagnosis of metastasis from the left renal cell carcinoma to the right testis. Three months post-surgery, the patient initiated treatment with a combination of axitinib and pembrolizumab. At the last follow-up, the patient had completed five cycles of targeted and immunotherapy, and there was no evidence of recurrence or metastasis.

Metastasis of renal cell carcinoma to the contralateral testis is a rare occurrence, and we reported a case. The patient had previously undergone radical left nephrectomy for clear cell carcinoma of the left kidney. Six years postoperatively, he presented with enlargement of the right testis and subsequently underwent radical orchiectomy. The postoperative pathological results confirmed the diagnosis of metastasis from the left renal cell carcinoma to the right testis. Three months post-surgery, the patient initiated treatment with a combination of axitinib and pembrolizumab. At the last follow-up, the patient had completed five cycles of targeted and immunotherapy, and there was no evidence of recurrence or metastasis.