Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 7 3 2022 11 01 105 108 Narjes Mohammadzadeh Department of General surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Seyed Mohammad Mahdi Hashemi School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2021 04 03 2022 01 30 In this case report, a man presenting with a rare symptom of appendix cancer is dis- cussed. Hematuria, which was the key diagnostic feature in this patient, has never been re- ported as a presenting feature of appendix cancer which may explain why this patient has been experiencing this symptom for months and yet have not get the proper di- agnosis. As we discussed in the case report, although appendiceal cancer is a potentially life-threatening issue, it is frequently missed in patients. Therefore, we believe report- ing this key symptom in this journal would help physicians to make a more accurate diagnosis in this matter.  https://crcp.tums.ac.ir/index.php/crcp/article/view/509