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Delays in diagnosis contribute to most patients having diffusely metastatic disease at the time of initial presentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We present the case of a 13\u2010year\u2010old African American male with sickle cell trait who presented with a renal mass and hematuria. Evaluation included imaging, fluid cultures, and cytologic assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patient was diagnosed with RMC based on cytologic assessment of sub\u2010centimeter fluid collections aspirated from the left kidney at the time of cortical biopsy for suspected renal mass. The additional fluid aspiration in conjunction with renal biopsy was an atypical but crucial step in early diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cytomorphologic evaluation of fluid biospecimens is not currently part of the standard work\u2010up for patients with renal masses but, when available, can provide crucial information that reduces time to diagnosis. Prompt symptom recognition and treatment initiation may improve patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.24854","type":"journal-article","created":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T02:14:28Z","timestamp":1677464068000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Diagnostic challenges of renal medullary carcinoma and the role for cytologic assessment: Case report and literature review"],"prefix":"10.1002","volume":"37","author":[{"given":"Benjamin O.","family":"Severseike","sequence":"first","affiliation":[{"name":"Phoenix Children's Hospital Residency Program Alliance (PCHRP) Phoenix Children's Hospital  Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristian T.","family":"Schafernak","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine Phoenix Children's Hospital  Phoenix Arizona USA"},{"name":"Department 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