Co-existing Hepatocellular Adenoma with Chromophobe Renal Cell Carcinoma – an Unusual Synchronous Tumor, a Case Report
DOI:
https://doi.org/10.21276/apalm.3978Keywords:
hepatocellular adenoma, chromophobe renal cell carcinoma, anabolic steroidsAbstract
Background: Anabolic androgenic steroid (AAS) consumption is associated with adverse hepatic and renal effects, including neoplastic transformation. However, the simultaneous occurrence of hepatocellular adenoma and chromophobe renal cell carcinoma following steroid exposure is exceptionally rare. We report a case highlighting this unusual association.
Case Presentation: A 40-year-old Indian male with chronic back pain and erectile dysfunction presented with intermittent, painless hematuria for three months. He had unknowingly consumed over-the-counter anabolic steroids for one year. Imaging revealed synchronous right renal and hepatic masses. The patient underwent robot-assisted right partial nephrectomy and laparoscopic hepatic resection. Histopathological examination of the renal mass revealed chromophobe renal cell carcinoma, characterized by cells with abundant eosinophilic cytoplasm and prominent cell membranes. Immunohistochemistry demonstrated positivity for CK7 and CD117 and negativity for CD10. The hepatic lesion exhibited sheets of bland hepatocytes with sinusoidal congestion, without significant atypia. Immunohistochemistry showed membranous beta-catenin expression and serum amyloid A positivity, supporting the diagnosis of inflammatory hepatocellular adenoma. Both lesions were completely excised with negative surgical margins. Postoperative and recent 3-year follow-up imaging demonstrated no residual tumour.
Conclusion: This case highlights the rare coexistence of chromophobe renal cell carcinoma and inflammatory hepatocellular adenoma in a patient with a history of inadvertent anabolic steroid consumption. Although a causal relationship cannot be established, the findings raise concerns regarding potentially serious consequences of unsupervised steroid exposure. Increased clinical awareness, careful medication history, appropriate surveillance, and stricter regulation of over-the-counter steroid-containing preparations are essential to minimize associated health risks.
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Copyright (c) 2026 Kuppuswamy Chandrasekaran Sharan, Jasleen Kaur, Paruvathavarthini Thambiraj, Bheemanathi Hanuman Srinivas, Sreerag Kodakkattil Sreenivasan
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