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To resect or not to resect? That is the question
  1. Mazen Noureddin1,
  2. David E Kleiner2,
  3. Ahmed M Gharib3,
  4. Gennady Bratslavsky4,
  5. Theo Heller1
  1. 1Liver Diseases Branch, The National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Maryland, USA
  2. 2Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Maryland, USA
  3. 3Integrative Cardiovascular Imaging Section, The National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Maryland, USA
  4. 4Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Maryland, USA
  1. Correspondence to Dr Mazen Noureddin, Liver Diseases Branch, The National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 10 Center Drive, Bldg 10 Room 4-5722, Clinical Center, Bethesda, Maryland 20892, USA; noureddinm{at}niddk.nih.gov

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Clinical presentation

A 54-year-old Caucasian female, with a strong family history of renal cell carcinoma, presented with a left kidney lesion. She had a hysterectomy 20 years ago and no significant history of oral contraceptive use. During the current evaluation, she was found to have two hypervascular lesions in the left lobe of the liver in addition to a fatty liver on CT scan as well as MRI (figure 1A–C). The largest lesion was 2 cm in size. She was asymptomatic. Physical examination showed an obese woman with body mass index of 35.6 with an otherwise normal exam. Her laboratory results showed an aspartate aminotransferase of 88 U/l, alanine aminotransferase of 75 U/l, alkaline phosphatase of 93 U/l, total bilirubin of 0.6 mg/dl and …

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