Abstract Body: Introduction
Renal cell carcinoma (RCC) is a recognized but rare cause of secondary hypertension. Hypertension in RCC can arise through several mechanisms, including direct renin secretion by the tumor (renin-secreting RCC), the tumor creating a mass effect on renal blood supply, decreasing it and activating the RAAS, or the presence of adrenal tissue within the tumor. Given these mechanisms, it is essential to consider renal tumors in the differential diagnosis of secondary hypertension.
This case reports uncontrolled hypertension as the presenting complaint in a young female with a chromophobe RCC.

Case Presentation
A 32-year-old female presented with intermittent headache, fatigue, and uncontrolled hypertension despite adherence to standard antihypertensive treatment. Laboratory tests revealed serum aldosterone at 37.9 ng/dL and markedly elevated plasma renin activity at 11.7 ng/mL/hr, suggesting hyperreninemic aldosteronism as the cause of her hypertension.
A CT scan revealed a large, mildly enhancing mass in the upper pole of the left kidney, measuring 93 x 92 x 96 mm (Figure 1).
Nephrectomy was discussed with the patient as part of her treatment plan and as a potential means of treating her hypertension. The patient consented, and the surgery was performed. Microscopic examination confirmed a chromophobe RCC extending into the renal sinus.

Conclusion
This case underscores the importance of considering RCC in the differential diagnosis of secondary hypertension, even in young adults. Early recognition and surgical intervention, such as nephrectomy, are crucial, as they may alleviate hypertension and potentially serve as an early indicator for tumor detection before further progression.