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International Journal of Surgical Pathology
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A Case of Liver Metastasis From an Oncocytoma With a Focal Area of Chromophobe Renal Cell Carcinoma: A Wolf in Sheep's Clothing

Muhammad I. Aslam, MBBS

Department of Hepatobiliary and Pancreatic Surgery, The Leicester General Hospital, Leicester, United Kingdom, imranaslam171{at}hotmail.com

Laura Spencer, MBChB, MRCS

Department of Hepatobiliary and Pancreatic Surgery, The Leicester General Hospital, Leicester, United Kingdom

Guiseppe Garcea, MRCS, MD

Department of Hepatobiliary and Pancreatic Surgery, The Leicester General Hospital, Leicester, United Kingdom

Chris Pollard, BA

Department of Hepatobiliary and Pancreatic Surgery, The Leicester General Hospital, Leicester, United Kingdom

Matthew S. Metcalfe, MRCS, MD

Department of Hepatobiliary and Pancreatic Surgery, The Leicester General Hospital, Leicester, United Kingdom

Rebecca F. Harrison, BSc, MBChB, FRCPath

Department of Histology, University Hospitals of Leicester, Leicester, United Kingdom

Ashley R. Dennison, MD, FRCS

Department of Hepatobiliary and Pancreatic Surgery, The Leicester General Hospital, Leicester, United Kingdom

In 2004, the World Health Organization classified the renal oncocytomas as benign neoplasms of the kidney. There are reports of subtypes of renal tumors, with similar histological morphology to oncocytoma, but with malignant potential, one of these tumors is the eosinophilic variant of chromophobe renal cell carcinoma. It is important to characterize the histological features and the subtype of tumor, as this predicts biological behavior and cancer-specific survival rate. A rare case of a liver metastasis from a focal area of eosinophilic variant of chromophobe renal cell carcinoma mixed in oncocytoma in a 69-year-old woman is reported. Although some renal tumors may contain oncocytoma and eosinophilic variant of chromophobe renal cell carcinoma histology, caution should be exercised while diagnosing oncocytomas in needle biopsies as there may be unsampled area of chromophobe carcinoma which has a potential for metastatic spread representing a wolf in sheep's clothing.

Key Words: oncocytoma • hybrid tumors • oncocytosis • chromophobe renal cell carcinoma • eosinophilic variant • liver metastasis

This version was published on April 1, 2009

International Journal of Surgical Pathology, Vol. 17, No. 2, 158-162 (2009)
DOI: 10.1177/1066896908318741
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