Metastatic renal cell carcinoma from a primary tumor removed 14 years previously.

It is not uncommon for renal carcinomas to present with a solitary metastasis. However, this patient was initially seen with multiple metastatic lesions. The five-year survival rate in such cases is very low, i.e., less that 5%. It is unfortunate that the initial diagnosis of Wilm's tumor was in error, as postoperative radiation therapy might have been of some value in ablation of residual tumor foci. It is, however, doubtful that radiation therapy and/or chemotherapy would have altered the eventual outcome of this disease. Although the diagnosis of a clear cell metastatic tumor to the head and neck is difficult because of the multiplicity of clear cell malignancies that can occur in this area, a primary tumor of the kidney must always remain high in the differential diagnosis.