KIDNEY - Carcinoma

Lower pole of kidney, expanded by a pale tumour some 12 cm. in maximum diameter; areas of necrosis apparent, but it does not have the usual yellow colour of a classical carcinoma. Posteriorly, the tumour appears to extend throught the cortex.
A 60-year-old man admitted following pain in left hip. X-rays showed both destruction of ileum and metastatic nodules in lung. A mass was felt in region of left kidney; this subsequently removed, providing the present specimen. Microscopy - poorly differentiated adenocarcinoma. He was subsequently found to have a metastasis in 7th cervical vertebra; laminectomy performed to decompress cord; following this his arms were largely deprived of power, but this improved. Three years later he shows some wasting in intrinsic muscles of right hand and has numbness in Tl dermatome; otherwise apparently well.