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We present a case report of a 64 years old female patient with renal carcinoma and metachronic metastases to the contralateral kidney, subcutaneous tissue and both adrenals glands during a course of 16 years after primary nephrectomy. Renal carcinoma metastases occur after several years most often in the area of the lungs, lymph nodes and the liver. At the time of diagnosis, approximately 25 % of patients have a generalized disease. The occurrence of metastases is dependent on the histological type, grade and size of the tumor. Bilateral metastases in the adrenal gland and the contralateral kidney are a challenge in the diagnosis and treatment of the disease because there are standard defined procedures for the treatment of these patients in the literature. We repeatedly used surgery because it seemed the most optimal solution in view of the development of the disease and the condition of the patient. [ABSTRACT FROM AUTHOR]