Osteoblastic metastases from a hypernephroma

Bone metastases are usually osteolytic, rarely osteoblastic. Sclerotic metastases have never been reported in renal cell carcinoma. A case of a hypernephroma with widespread sclerotic metastases is reported. The patient was a 34-year-old male first seen at the Royal Marsden Hospital on July 15, 1967. He presented with a history of anorexia, weight loss and low backache. On examination he was emaciated and had a palpable right kidney. A rectal examination was normal. One month previously, when in the United States, he was shown to have a mass lesion of the right kidney. A biopsy then from his posterior superior iliac crest was reported as showing clear cell metastatic tumour.