The common metastatic pathways of kidney cancer are as follows: (1) direct spread: the tumor is too large to invade adjacent tissues and organs, such as adrenal gland and lymph nodes, etc. It is also easy to spread into the veins and form cancer emboli, and in serious cases, the cancer embolus can enter the heart; (2) hematogenous metastasis: the most common site is lung, followed by liver, bone, brain, skin, thyroid gland, etc. It can also metastasize to the opposite kidney; (3) lymphatic metastasis: it can occur in the renal hilum, between the aorta and vena cava, supraclavicular and subdiaphragmatic lymph nodes.