It's not renal carcinoma.

It's fairly obvious that this patient had an aggressive renal adenocarcinoma that had metastasised to several areas; you noticed the mets, in the adrenals and the lung, but there may have been other smaller focal lesions in the brain that were not easily visible. However, the patient didn't die as a direct result of the action of any single tumour - this means that the immediate cause of death wasn't renal carcinoma.

Confused? you should be...