Interesting ImagesA Von Hippel-Lindau Disease–Associated Microcystic Adenoma of the Ethmoid Sinus Mimicking Metastatic Clear Cell Renal Cell CarcinomaTsukamoto, Suzune MD∗; Koyasu, Sho MD, PhD∗,†; Sugimoto, Akihiko MD‡; Matsunaga, Mami MD, PhD§; Nakamoto, Yuji MD, PhD∗ Author Information From the ∗Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine †Center for von Hippel-Lindau Disease, Kyoto University Hospital ‡Department of Diagnostic Pathology, Graduate School of Medicine §Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Received for publication July 31, 2022; accepted August 31, 2022. Conflicts of interest and sources of funding: The present study was financially supported by the JSPS KAKENHI (grant 22K15879). The authors have no potential conflicts of interest to disclose. Correspondence to: Sho Koyasu, MD, PhD, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan. E-mail: [email protected]. Clinical Nuclear Medicine 48(2):p 194-196, February 2023. | DOI: 10.1097/RLU.0000000000004421 Buy Metrics Abstract A 38-year-old man with von Hippel-Lindau (VHL) disease and a history of renal cell carcinoma presented with a 2-month history of recurrent epistaxis. MRI revealed a microcystic tumor in the left ethmoid sinus with strong contrast enhancement. 18F-FDG PET/CT showed FDG uptake (SUVmax, 4.2) in the lesion. Under the suspicion of renal cell carcinoma metastasis, the patient underwent 2 surgical resections. However, based on the morphological and immunohistochemical findings, the patient was finally diagnosed with a VHL-associated microcystic adenoma of the ethmoid sinus, which is an extremely rare tumor that occurs in VHL disease. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.