Gestational trophoblastic neoplasia (GTN) is a hemorrhagic malignancy with highly rapid potential metastasis via hematogenous spreading. Renal metastasis is of infrequent occurrence. Among previous case reports of renal metastasis in GTN, this is the youngest woman presenting a large renal lesion concurrent with pulmonary and brain metastases. Disease remission had been achieved by treatment with combined chemotherapy and whole brain radiation, although acute myeloblastic leukemia (AML) developed later.