Renal neoplasm is the most frequent cause of metastases, after prostatic and breast carcinoma. Lesions are aggressive and expansive with cortical destruction and soft tissue extension. Pathological fracture is very common, up to 50%. The most frequent localizations are long bones, spine and pelvis. Aim of this work is to evaluate the usefulness of surgical treatment of soft tissue and skeletal metastases in kidney neoplasm. Between 1995 and 2005 66 patients (40 males, 26 females) were submitted to surgical treatment at San Raffaele Hospital, Milano. Most common localizations were femur, humerus, spine, pelvis, metatarsus. We report 3 cases of soft tissue metastases of lower limb. Twenty-five patients had single localization, 10 pathological fracture and in 5 diagnose was bioptical. Surgical treatment was performed with large resection and in 15 patients the lesion was embolized. Twelve patients had local relapse and in 3 we performed a new surgical treatment. We had no infections nor fatal outcome in the post-surgical period.
