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Table 4 Summary table of local, nodal and haematogenous spread in renal cell carcinoma

From: Common primary tumours of the abdomen and pelvis and their patterns of tumour spread as seen on multi-detector computed tomography

Local spread •Perinephric fat; ipsilateral adrenal; adjacent viscera (including muscles);
•Renal vein invasion (± IVC)
Lymph node spread •Via lymphatics following the renal vessels to the ipsilateral para-aortic nodes; direct connections with the thoracic duct and mediastinum also exist
Haematogenous spread •Common sites: lungs > bones, CNS, adrenals
Note •Extension into renal vein occurs in 20% of patients at presentation; IVC involvement in 5–10%