Neoplastic progression proceeds most commonly with metastatic spreading but also with direct spreading and some minor forms of neoplastic distribution. The difference between metastatic spreading and direct tumor spreading is shown by the fact that metastatic cells are motile and separate from the primary tumor, whereas in direct spreading the progressing cells are less motile and connected with the primary tumor. This latter type of spreading is especially common in kidney cancers. In the case of local recurrence where portions of the primary tumor have been spared from destruction, regrowth of these portions may occur after different intervals. It is a precondition that the neoplastic metabolism has gained power again. Local recurrence is an offspring of growth from the primary tumor or from a not fully removed metastasis and should be considered as a growth comparable to direct spreading. It may switch during further progression to metastatic progression.