A case is presented of an adult male with an advanced right renal adenocarcinoma demonstrated by angiography and bilateral pulmonary metastases demonstrated by chest roentgenograms and laminography. Approximately 5 months after completion of irradiation of the primary tumor, before nephrectomy was performed, the pulmonary metastases had disappeared and have remained so for approximately ZY2 years, or approximately 3 years after diagnosis of the tumor. The patient remains clinically free of tumor and is well enough to work regularly. This case appears to add evidence that palliative treatment, including irradiation, to far-advanced primary renal adenocarcinoma may be of value to more patients than formerly realized.
N RECENT YEARS THERE HAVE BEEN A NUMBER I of reports dealing with "spontaneous" remissions of tumor, some concerning pulmonary metastases from renal adenocarcinoma. Since reviews are available,lv 2 , 4, 5 the entire literature will not be reviewed here. T h e term "spontaneous" is probably best used in a qualified sense, as, in most reported cases, there had been interferences with the natural course of the disease by some sort of surgery. I t is believed that this is the second reported case of disappearance of apparent pulmonary metastatic lesions following irradiation of the primary renal tumor,e and the first with longterm regression. CASE HISTORY J.N., a 36-year-old Caucasian man, was admitted on 10/23/67 with a 3-month history of persistent hematuria and 45 lb. weight loss (to 165 lb.). He also complained of loss of energy, but with no pain and without other urinary symptoms. Incidental history included episodes, some severe, of "indigestion" for 8-9 years, partially controlled by antacids, Blood pressure was 140/80; TSP, 7.6 mg/100 ml; Hgb, 11.3 g/100 ml; Hct, 337&; WBC, 15,300 normal differential. O n urography, then renal arteriography (Fig. l), there was evidence of a large mass occupying the upper pole of the right kidney, with vascular pattern typical of renal adenocarcinoma. On chest roentgenograms (Figs. 2, 3,) both plain films and laminography, there was evidence, in both lung