A 56-year-old man underwent a right radical nephrectomy with removal of a vena caval thrombus and resection of hepatic metastases for right renal cell carcinoma. Twenty-one months after the first operation, a left renal cell carcinoma was detected which was treated with left radical nephrectomy and followed by hemodialysis. The patient then enjoyed an active life for 14 months but died 18 months after his second operation due to lung metastasis. Bilateral radical nephrectomy and hepatic resection may be justified since there is no strongly effective adjuvant therapy for such advanced cases.