Huge bilateral polycystic kidneys with suspicion of malignancy, recurrent bleeding in cysts, and acute abdomen

We present a case of huge bilateral polycystic kidneys, with suspicion of malignancy and repeated admissions with acute abdomen, secondary to bleeding in cysts, and anaemia, requiring affected side nephrectomy. KEY MESSAGE: Autosomal dominant polycystic kidney disease (ADPKD) mostly ends up with end stage renal disease (ESRD), requiring haemodialysis, with increased risk of malignancy and enlargement of kidneys with its associated complications, mostly dealt with conservatively, except malignancy, which requires nephrectomy.