Patients with metastatic renal cell carcinoma(RCC) usually have a dismal prognosis with a median survival duration of 12 months despite intensive systemic therapy of varioue modalities. The role of surgical removal of metastatic tumor is controversial, RCC usually shows predictable pattern of metastasis, preferentially to lung, lymph node, bone, liver and adrenaL It is rare for general surgeon to have a chance to see and operate the metastatic RCC. We herein report two cases of RCC which produced metastaaes of odd pattern and were treated by surgical removal of the metastatic organ at the department of general surgery with good outcomes. One patient presented with RCC with metastasis to gall bladder, which was treated by radical nephrectomy and cholecystectomy. The other patient presented with thyroid mass, which was confirmed as metastatic RCC after thyroidectomy. He had history of surgery for metastatic RCC to skin, lung and ethmoid bone sequentially every 2 years during past 9 years after nephrectomy. The 2 cases suggest that RCC can produce metastases of very unusuall location, induding gall bladder and thyroid and preaentation long time after nephrectomy, and in which cases ag- gressive surgical removal of the metaatatic tumor may be of benefit.
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