Metastatic deposits from a previously treated carcinoma of the lung presenting as a renal cell carcinoma

Two patients are presented who had each previously undergone resection of a primary lung carcinoma. They later developed the classical triad of loin pain, haematuria and an abdominal mass suggestive of a primary renal tumour. Investigations, including intravenous urography, ultrasound and renal arteriography, supported the diagnosis. However, at operation both patients had para-aortic lymph node metastases from the lung carcinoma surrounding the renal pedicle and invading the renal parenchyma. It is suggested that further investigations might allow pre-operative diagnosis and thus avoid the need for surgery in such patients.