Metastases to the skin from a renal cell carcinoma as first evidence of the disease may not be as rare as the literature describes. Definite proof of the origin of the tumour requires specialized immunohistochemical techniques.

We report a case of renal cell carcinoma with an extensive intraperitoneal metastasis at the time of diagnosis. This type of metastasis is very rare for renal cell carcinoma and is identified in only 1 % of the metastases at autopsy. The findings of computed tomography are presented.

Twenty-four patients with medullary sponge kidneys (MSKs), diagnosed on a recent IVU, and renal lithiasis were treated by extracorporeal shock wave lithotripsy (ESWL). A detailed history regarding frequency of renal colic and urinary tract infection (UTI) was recorded and compared to the post-ESWL frequency of the symptoms. Our results show that the stone clearance rate is similar to that of non-MSK patients but there is a great reduction in the frequency of renal colic and UTI.

A case of right renal adenocarcinoma in a 36-year-old female is reported. The tumour involved the IVC by direct extension and infiltration. Cavography showed complete obstruction of the IVC by thrombus. A right nephrectomy was performed. The obstructed IVC was partially excised and reconstructed using a patch of PTFE artificial graft.