Germ line mutations of the gene encoding the tricarboxylic acid (TCA) cycle enzyme fumarate hydratase (FH) cause a hereditary cancer syndrome known as hereditary leiomyomatosis and renal cell cancer (HLRCC). HLRCC-associated tumors harbor biallelic FH inactivation that results in the accumulation of the TCA cycle metabolite fumarate. Although it is known that fumarate accumulation can alter cellular signaling, if and how fumarate confers a growth advantage remain unclear. Here we show that fumarate accumulation confers a chronic proliferative signal by disrupting cellular iron signaling. Specifically, fumarate covalently modifies cysteine residues on iron regulatory protein 2 (IRP2), rendering it unable to repress ferritin mRNA translation. Simultaneously, fumarate increases ferritin gene transcription by activating the NRF2 (nuclear factor [erythroid-derived 2]-like 2) transcription factor. In turn, increased ferritin protein levels promote the expression of the promitotic transcription factor FOXM1 (Forkhead box protein M1). Consistently, clinical HLRCC tissues showed increased expression levels of both FOXM1 and its proliferation-associated target genes. This finding demonstrates how FH inactivation can endow cells with a growth advantage.KEYWORDS ferritin, FH, FOXM1, fumarate, HLRCC, NRF2 H ereditary leiomyomatosis and renal cell cancer (HLRCC) patients carry a germ line-inactivating mutation in one of the fumarate hydratase (FH) alleles and are prone to developing skin leiomyomas, uterine fibroids, and renal cell carcinoma of type 2 papillary morphology (1). HLRCC-associated tumors harbor a loss of heterozygosity at the FH locus, indicating biallelic FH inactivation as the tumor-initiating event (1). However, it remains unclear how FH inactivation drives carcinogenesis.The most direct consequence of FH inactivation is intracellular fumarate accumulation. Accumulated fumarate can covalently modify cysteine residues of proteins in an uncatalyzed process termed succination and cause many alterations in cellular signaling (2). Succination in HLRCC cells was first discovered on Kelch-like ECH-associated protein 1 (KEAP1), a negative regulator of the nuclear factor (erythroid-derived 2)-like 2 (NRF2) transcription factor (3). Since HLRCC is driven by FH inactivation, chronic succination of KEAP1 results in constitutive NRF2 activation and increased expression of its target genes (3). Besides KEAP1, the Krebs cycle enzyme aconitase 2 (Aco2) was reported to be a succination target in Fh knockout mouse tissues, and succination inhibited its activity (2). Despite dramatic cellular changes induced by protein succina-