Hypernephroma reputedly produces more solitary distant metastases than any other malignant tumor. The primary site is frequently silent, and the diagnosis is frequently made from a study of the distant implant. Apparent isolated metastases have been described in the lung,1 brain,2 bone,3 pancreas,4 thyroid,5 testis,6 and vagina.7
An occasional attempt has been made at resection of the metastasis. In some instances the operator thought he was treating a primary tumor; in others the primary tumor seemed to be under control and an attack on a solitary metastasis appeared justified. Sometimes this appears to have been successful.
Herbst8 resected an isolated metastasis in the region of the duodenal papilla, and the patient was well six months later. Jenssen's4 patient was well nine months after resection of an implant in the head of the pancreas. Riches, Griffiths, and Thackray9 report removal of