CASE REPORT article
Front. Oncol.
Sec. Genitourinary Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1605192
This article is part of the Research TopicKidney Cancer Awareness Month 2025: Current Progress and Future Prospects on Kidney Cancer Prevention, Diagnosis and TreatmentView all 4 articles
Synchronous Papillary Renal neoplasm with Reverse Polarity and Multilocular Cystic Renal Neoplasm of Low Malignant potential in Unilateral Kidney: Case report with molecular analysis and Literature review
Provisionally accepted
- 1MedStar Georgetown University Hospital, Washington D.C., United States
- 2Department of Urology, MedStar Georgetown University Hospital, Washington, DC, District of Columbia, United States
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Papillary Renal Neoplasm with Reverse Polarity (PRNRP) is a rare renal tumor, recently described in 2019 by Al-Obaidy et al defined by characteristic histology of papillary neoplasm with apically located WHO/ISUP grade 1nuclei and frequent KRAS mutations. Multilocular cystic renal neoplasm of low malignant potential (MC-LMP) is an indolent tumor with a characteristic multicystic appearance with cysts lined by WHO/ISUP nuclear grade1 clear cells and presence of VHL alterations similar to that of clear cell renal cell carcinoma (ccRCC); therefore, considered its variant. Simultaneous occurrence of both these tumor types that are immunophenotypically and genetically distinct within same kidney is extremely rare and this is the first case report to date. Herein, we report a case of a 70-year-old male who was incidentally found to have bilateral renal cysts on imaging follow up for cardiovascular problems. The diagnosis of PRNRP and MC-LMP within the same kidney was made on histology in conjunction with ancillary tests. Awareness of PRNRP and MC-LMP is crucial for accurate diagnosis, as these tumors often resemble some of the aggressive variants of Renal cell carcinoma (RCC), such as Papillary RCC (pRCC) and ccRCC respectively on histology. Ability to correctly identify these indolent tumors is essential for optimal treatment options as they are often amenable to partial nephrectomy. This case underscores the need for further research into the pathogenesis and clinical implications of synchronous renal tumors with distinct immunophenotypes, and genomic profiles within the same kidney.
Keywords: Papillary renal neoplasm with reverse polarity, multiloculate cystic renal neoplasm of low malignancy potential, synchronous renal tumors, KRAS mutation, renal neoplasm pathogenesis
Received: 03 Apr 2025; Accepted: 22 Jul 2025.
Copyright: © 2025 Nithagon, Chahine, Stamatakis and Samdani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Pichayut Nithagon, MedStar Georgetown University Hospital, Washington D.C., United States
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