Papillary renal neoplasm with reverse polarity
Authors:
Petr Stránský jr. 1; Adriena Bartoš Veselá 1; Jan Pernický 2; Tra Mi Nguyenová 1; Milan Hora 1; Ondřej Fiala 3,4; Kristýna Pivovarčíková 5,6
Authors‘ workplace:
Urologická klinika LF UK a FN Plzeň
1; Klinika zobrazovacích metod LF UK a FN Plzeň
2; Onkologická a radioterapeutická klinika LF UK a FN Plzeň
3; Biomedicínské centrum, LF UK v Plzni
4; Šiklův ústav patologie, LF UK a FN Plzeň
5; Bioptická laboratoř, s. r. o., Plzeň
6
Published in:
Ces Urol 2026; 30(3): 142-145
Category:
Case report
doi:
https://doi.org/10.48095/cccu2026019
Overview
Major statement: Papillary renal neoplasm with reverse polarity represents a newly emerging neoplastic entity with distinct morphological and molecular features and documented indolent behavior. Here, we present a case report of a 74-year-old man.
Papillary renal neoplasm with reverse polarity (PRNRP) is a newly emerging entity within the spectrum of papillary renal tumors. This entity is characterized by specific histological features and a typical molecular background, which distinguish it from conventional forms of papillary renal cell carcinoma. To date, several hundred cases have been documented in the literature. Published data associate PRNRP with indolent clinical behavior and a favorable prognosis. Increasing clinicopathological and molecular evidence supports the biological distinctiveness of this entity, whose position within the WHO classification of renal tumors will likely be further clarified in the future. Here, we present a case report of a 74-year-old patient diagnosed at our institution. The tumor was incidentally detected during imaging examination and was treated by laparoscopic radical nephrectomy without complications. The histological findings corresponded to pT1a disease with negative surgical margin. The patient is 6 months after surgery in good clinical condition, with no clinical signs of disease recurrence or progression.
Keywords:
WHO classification – eosinophilic – oncocytic – papillary renal carcinoma – reverse polarity
Sources
1. Al-Obaidy KI, Eble JN, Cheng L et al. Papillary renal neoplasm with reverse polarity: a morphologic, immunohistochemical, and molecular study. Am J Surg Pathol 2019; 43(8): 1099–1111. doi: 10.1097/PAS.0000000000001288.
2. Al-Obaidy KI, Eble JN, Nassiri M et al. Recurrent KRAS mutations in papillary renal neoplasm with reverse polarity. Mod Pathol 2020; 33(6): 1157–1164. doi: 10.1038/s41379-019-0362-1.
3. WHO classification of tumours editorial board. Urinary and male genital tumours. WHO classification of tumours. 5th ed. Lyon: IARC 2022.
4. Trpkov K, Siadat F, Saleeb R et al. Recent developments in eosinophilic renal neoplasms: what’s new, true and important? Histopathology 2026; 88(1): 166–192. doi: 10.1111/his.70001.
5. Hes O, Michalová K, Pivovarčíková K. Novinky ve WHO klasifikaci renálních nádorů 2022. Čes Slov Patol 2022; 58(4): 187–191.
6. Delahunt B, Eble JN. Papillary renal cell carcinoma: a clinicopathologic and immunohistochemical study of 105 tumors. Mod Pathol 1997; 10(6): 537–544.
7. Saleeb RM, Brimo F, Farag M et al. Toward biological subtyping of papillary renal cell carcinoma with clinical implications through histologic, immunohistochemical, and molecular analysis. Am J Surg Pathol 2017; 41(12): 1618–1629. doi: 10.1097/PAS.0000000000000962.
8. Linehan WM, Spellman PT, Ricketts CJ et al. Comprehensive molecular characterization of papillary renal-cell carcinoma. N Engl J Med 2016; 374(2): 135–145. doi: 10.1056/NEJMoa1505917.
9. Pitra T, Pivovarčíková K, Alaghehbandan R et al. Chromosomal numerical aberration pattern in papillary renal cell carcinoma: review article. Ann Diagn Pathol 2019; 40 : 189–199. doi: 10.1016/j.anndiagpath.2017.11.004.
10. Hora M, Albiges L, Bedke J et al. European Association of Urology guidelines panel on renal cell carcinoma update on the new World Health Organization classification of kidney tumours 2022: the urologists point of view. Eur Urol 2023; 83(2): 97–100. doi: 10.1016/j.eururo.2022.11.001.
11. Nova-Camacho LM, Martin-Arruti M, Diaz IR et al. Papillary renal neoplasm with reverse polarity: a clinical, pathologic, and molecular study of 8 renal tumors from a single institution. Arch Pathol Lab Med 2023; 147(6): 692–700. doi: 10.5858/arpa.2022-0156-OA.
12. Hes O, Brunelli M, Michal M et al. Oncocytic papillary renal cell carcinoma: a clinicopathologic, immunohistochemical, ultrastructural, and interphase cytogenetic study of 12 cases. Ann Diagn Pathol 2006; 10(3): 133–139. doi: 10.1016/j.anndiagpath.2005.12.002.
13. Pivovarčíková K, Grossmann P, Hájková V et al. Renal cell carcinomas with tubulopapillary architecture and oncocytic cells: molecular analysis of 39 difficult tumors to classify. Ann Diagn Pathol 2021; 52 : 151734. doi: 10.1016/j.anndiagpath.2021.151734.
14. Wei S, Kutikov A, Patchefsky AS et al. Papillary renal neoplasm with reverse polarity is often cystic: report of 7 cases and review of 93 cases in the literature. Am J Surg Pathol 2022; 46(3): 336–343. doi: 10.1097/PAS.0000000000001773.
15. Chen G, Liao X, Liu W et al. Bilateral synchronous papillary renal neoplasm with reverse polarity and renal cell carcinoma with fibromyomatous stroma: a case report and review of the literature. Front Oncol 2025; 15 : 1668258. doi: 10.3389/fonc.2025.1668258.
16. Castillo VF, Trpkov K, Van der Kwast T et al. Papillary renal neoplasm with reverse polarity is biologically and clinically distinct from eosinophilic papillary renal cell carcinoma. Pathol Int 2024; 74(4): 222–226. doi: 10.1111/pin.13417.
Labels
Paediatric urologist Nephrology UrologyArticle was published in
Czech Urology
2026 Issue 3
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