BRITISH MEDICAL JOURNAL 26 MARCH 1977 817 been a total of 19 cases in seven families reported, our patients bringing the total to 21 cases in eight families. The familial incidence of hypernephromas may be fortuitous, but if a genetic factor is present the question of screening other members of the family arises. Brinton2 and Steinberg et al3 reported hypernephroma in two generations and it would therefore seem reasonable to carry out regular five-year investigations in the other siblings and the children of our two brothers.We thank Professor N C Nevin for his help, and Mrs D Cranston for typing the manuscript.

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