On the 2018, the prevalence of kidney cancer is 3.9% of all cases of cancer in the Russian Federation. The 5-year survival rate patients with RP is approximately 60%, while in the presence of distant metastases, the 5-year survival rate is from 5 to 9%. The case presented of operational treatment of a patient with metachronous metastasis clear-cell renal cell cancer of the right kidney into the paranephric cellulose of the contralateral the only left kidney. In 1999, the patient underwent a radical nephrectomy on the right side regarding kidney carcinoma. No data for distant metastases were received, chemotherapy was not carried out for the patient, after surgery was observed on an outpatient basis by an oncologist. Removed from the register by an oncologist after 5 years. Since 2019, the patient began to notice relapses of renal colic, in March 2020 he was hospitalized in the urology department of the North-Western Medical University named after I.I. Mechnikov, according to emergency indications with a clinical picture of renal colic on the left. The patient underwent MSCT of the abdominal organs with intravenous contrast. The formation of retroperitoneal space on the left was revealed, measuring 11.0×10.1×9.2 cm, accumulating contrast and adjacent to the left kidney. There are no data for other focal formations in the abdominal cavity. The left kidney is located typically, increased in size. The patient underwent surgery in the amount of resection of retroperitoneal education. According to the results of histological examination: the picture more corresponds to with metastasis of clear cell renal-cell carcinoma of the kidney Grade 1. ICD-0 8310/3. The presented clinical case is valuable in that kidney carcinoma metachronic metastasis was detected only after 21 years, at the same time, it had an extraorgan arrangement in the retroperitoneal space, lying tightly on the kidney, but did not grow into the renal capsule. Based on this, we consider it important to continue monitoring patients after radical nephrectomy about a kidney tumor, even beyond the pale of 5 year survival.