Adenocarcinomas of the kidney are rare tumors. This malignancy has been called the "internist's tumor" because of its often unusual presentation and systemic symptoms. The diagnosis is largely based on urography, sonography and CT-scan. Radical tumornephrectomy is the only treatment with curative potential. Interventional angiography with tumor embolization has become an important tool for palliation. On the other hand, the results of systemic treatment, such as hormone therapy, chemotherapy or immunotherapy, remain disappointing.