THE PROGNOSIS for patients with renal carcinoma is uncertain. Several studies indicate that only 18% to 23% survive ten years after nephrectomy.1-3 Approximately 37% have metastases, and in 41% the primary tumor is nonresectable at the time of first examination.4 Yet instances of slow development of renal carcinoma,5,6 regression of the primary tumor,7 and even disappearance of distant metastases do occur.8-12 Occasionally metastases appear many years after nephrectomy,13-21 which makes their relation to the primary tumor questionable. The following report is, we believe, of the longest known interval between nephrectomy and well-documented recurrence of renal carcinoma. Report of Case An asymptomatic 66-year-old white woman was found during routine physical examination to have a mass in the right upper quadrant of the abdomen and was admitted to the hospital for diagnostic study. She had undergone transabdominal right nephrectomy for renal carcinoma 31 years previously. After