We report a case of metastatic collecting duct carcinoma (CDC) incidentally found on computer assisted tomography in an 18-year-old male who presented status post a motor vehicle crash (MVC). The patient underwent total nephrectomy/renal vein thrombectomy with retroperitoneal lymph node dissection, followed by multimodal therapy, with gemcitabine and platinum salt therapy, effecting a short lived complete response, followed by single agent paclitaxel chemotherapy effecting a similarly short lived partial response. We conclude that cytoreductive nephrectomy and lymphadenectomy combined with chemotherapy may be useful for extending and increasing the quality of life of selected patients with CDC.