We present the first reported case of a perirenal well-differentiated liposarcoma containing extramedullary hematopoiesis associated with an ipsilateral T2N0M0 renal cell carcinoma. This patient, a seventy-one-year-old white male, had no known hematologic disorder and on preoperative evaluation had similar radiographic findings identified within the contralateral perirenal space. Pathologic evaluation after radical nephrectomy reported the perirenal mass to consist only of myelolipomatous change, however, further review identified liposarcoma.