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Bilateral leiomyosarcoma of kidneys with pericardial metastases: a double whammy. Renal sarcoma is a rare but lethal malignancy affecting the kidneys. Literature regarding this rare tumour has been limited to case reports and case series. In this paper, we report a very rare case of bilateral renal leiomyosarcoma with pericardial metastasis. Disease status and dearth of our knowledge in treating this particular type of case prompted us to review our experience of managing such case, which has never been reported previously in literature to our knowledge.