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Int J Clin Exp Pathol 2(2),190-193;2009

Case Report
Metastatic Renal Cell Carcinoma within a Hepatic Focal Nodular Hyperplasia: A Case
Report and Review of the Literature

Yurong Y. Wheeler, Guy L. Wheeler, Alberto A. Diaz-Arias and Robert A. Anders

Department of Pathology, The Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21287; Departments of Radiology and Pathology
and Anatomical Sciences, University of Missouri-Columbia, One Hospital Drive, Columbia, MO 65212 and Division of Gastrointestinal and Liver
Pathology, The Johns Hopkins Hospital, 1550 Orleans St., Baltimore MD 21231.

Received 3 April 2008; Accepted in revision 9 May 2008; Available online 9 June 2008

Abstract: A patient with microscopic metastatic renal cell carcinoma within liver focal nodular hyperplasia (FNH) is reported here. The initial CT
scan was classic for liver FNH yet the following liver resection showed a microscopic metastatic renal cell carcinoma (0.48 cm) within the liver
nodule. FNH in a patient with existing primary tumor probably warrants further investigation as the coexistence of metastatic disease may
significantly alter treatment. The high arterial blood flow in the liver FNH may predispose the region to develop a metastatic tumor. Also possible
is that a metastatic tumor may cause a local vascular flow abnormality which induces hepatocellular hyperplasia, resulting in a secondary FNH.
(IJCEP803017).

Key Words: Focal nodular hyperplasia, metastatic renal cell carcinoma, computed tomographic (CT) scan

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Address all correspondence to: Yurong Wheeler, M.D., Ph.D., Department of Pathology, Room 406, The Johns Hopkins Hospital, 600 N. Wolfe
Street, Baltimore, MD 21287. Tel: 410-955-1246; Fax: 410-614-9556; Email:
ywheele4@jhmi.edu