Abstract
The renal cell carcinoma, known also as hypernephroma and Grawitz tumor, is one of the present-day entities replacing syphilis as a medical enigma. The disorder presents occasionally with anemia, erythremia, pyrexia of unknown etiology, hypercalcemia, or salt-losing syndrome and demands respect (12). For the radiologist, too, there are many confusing aspects concerning the sites and time of appearance of metastases, difficult not only to predict, but also to explain. Because a better understanding of the modes of spread could help in earlier diagnosis, rationale of treatment, and method of follow-up, 152 cases of proved hypernephromas, including 49 followed until necropsy, were studied retrospectively. Spread via the lymphatics and the paravertebral plexus of veins was found to playa more important role than generally appreciated. Lymph Node Metastases Nodes of the renal pedicle and paraaortic areas are sometimes involved at surgery, but little attention is focused on this in subsequent patient follow-up....
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