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Renal cell carcinoma (RCC) is a relatively rare solid tumour: it comprises ca. 3% of all malignant neoplasms among adults. The most common histological RCC type (70–80% of renal neoplasms) is clear cell cancer. At diagnosis 30% of patients with this tumour have distant metastases, and in 20% of cases it is considerably advanced locally [1, 2]. Moreover, following nephrectomy, 20% to 30% of RCC patients in whom the tumour only affects the kidneys, on average will have a local recurrence and/or distant metastases after 15 to 18 months, while in 85% the disease will recur within 3 years [3]. Metastases may also appear more than 10 years after surgical treatment. The most common metastatic sites for bloodstream-spread are the lungs, liver, brain, and bones [3, 4]. The second way in which the tumour can spread is via the lymphatic vessels. Renal cell carcinoma patients may have distant metastases in atypical locations, i.e. the skin, thyroid, and pancreas. Resectable RCC metastases found in post-nephrectomy follow-ups should be removed surgically since metastasectomy sometimes enables long-term survival [2].

Renal cell carcinoma metastases to the pancreas and the thyroid gland 19 years after the primary tumour