 Littoral cell angioma, LCA, is a rare benign tumor originating exclusively from the venous sinus lining cells of the splenic red pulp. These cells are unique in having a distinctive hybrid endothelial histiocytic phenotype. Also, there are reports of the association of LCA with internal malignancies. We present a case report highlighting an unusual association of LCA with conventional renal cell carcinoma, RCC, masquerading as a metastatic lesion. Knowledge of such an association is necessary to avoid misdiagnosis and prevent potential over-treatment. This article was authored by T. Adewal, S. S.S.P., G. Prakash and others.