As expressed in their case report, the best available treatment for UCD remains surgical resection, while MCD often responds to Rituximab and other interleukin-6 (IL-6) targeted therapies [8]. Discussed below is a challenging case wherein multiple imaging modalities and pre-operative biopsies did not yield a definitive diagnosis due to the significant overlap with other pathologies such as lymphoma and carcinoid tumours. The gene discussed is IL6; the disease is urea cycle disorder.