Ces Urol 2026, 30(3):142-145 | DOI: 10.48095/cccu2026019

Papillary renal neoplasm with reverse polarity

Petr Stránský jr.1, Adriena Bartoš Veselá1, Jan Pernický2, Tra Mi Nguyenová1, Milan Hora1, Ondřej Fiala3,4, Kristýna Pivovarčíková5,6
1 Urologická klinika LF UK a FN Plzeň
2 Klinika zobrazovacích metod LF UK a FN Plzeň
3 Onkologická a radioterapeutická klinika LF UK a FN Plzeň
4 Biomedicínské centrum, LF UK v Plzni
5 Šiklův ústav patologie, LF UK a FN Plzeň
6 Bioptická laboratoř, s.r.o., Plzeň

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.

Summary: 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: eosinophilic – oncocytic – papillary renal carcinoma – reverse polarity – WHO classification

Received: May 17, 2026; Revised: June 21, 2026; Accepted: June 24, 2026; Published: September 21, 2026 


References

  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. Go to original source... Go to PubMed...
  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. Go to original source...
  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. Go to original source...
  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. Go to original source... Go to PubMed...
  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. Go to original source...
  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. Go to original source... Go to PubMed...
  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 urologist�s point of view. Eur Urol 2023; 83(2): 97-100. doi: 10.1016/j.eururo.2022.11.001. Go to original source...
  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. Go to original source... Go to PubMed...
  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. Go to original source... Go to PubMed...
  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. Go to original source... Go to PubMed...
  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. Go to original source... Go to PubMed...
  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. Go to original source... Go to PubMed...
  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. Go to original source... Go to PubMed...





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