Presentation
Weight loss, loss of appetite, anemia, shortness of breath
Patient Data
![](https://prod-images-static.radiopaedia.org/images/52960141/1f4a2c0e3bc2dc8272a8db6693a0beae671acc9cdbdbb59388ac99199d619a32_big_gallery.jpeg)
Large nodular opacities scattered in both lungs, compatible with cannonball pulmonary metastases.
![](https://prod-images-static.radiopaedia.org/images/52969270/f753c165f0038d9ed3541530600dfb305fbdc263a007c27f8fb525ba4ca0a487_big_gallery.jpeg)
Large right renal tumor with extension into the perinephric tissue and tumor thrombus extending into renal vein and infra-diaphragmatic inferior vena cava. Right renal hilar and aortocaval lymph adenopathy.
Associated with pericardial metastases, lung metastases, aortopulmonary mediastinal lymph node mass, multiple muscle metastasis in bilateral supraspinatus muscles, right iliacus, and left quadratus lumborum muscles.
Case Discussion
This case illustrates the typical pattern of spread of renal cell carcinoma metastases.