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Over 1/3 of patients with renal cell carcinoma will present with metastases with no symptoms referable to the kidney. Early metastatic disease is a result of the unique accessibility of the kidney to lymphohematogenous pathways. The thorax is particularly vulnerable. Several of the more unusual manifestations involving the thorax are illustrated, including 1 case with intra-alveolar metastases.
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Latour et al. (1976) studied this question.
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