Although the patient from Case 1 was never diagnosed with renal cell cancer and had no family history of cancer or leiomyomatosis, the presence of multiple cutaneous and uterine leiomyomas (MCUL) and the lack of expression of fumarate hydratase in the lung tissue we had access to points to a possible HLRCC syndrome diagnosis. The gene discussed is FH; the disease is renal cell adenocarcinoma.