{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:03:09Z","timestamp":1785301389937,"version":"3.55.0"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>\n                    Papillary renal neoplasm with reverse polarity (PRNRP) is an emerging entity with an indolent clinical course. It is histologically characterized by a low-grade papillary neoplasm with apically located nuclei and frequent\n                    <jats:italic>KRAS<\/jats:italic>\n                    mutation. With the limited amount of literature, there is no established association between PRNRP and other diseases. Herein, we report four patients of PRNRP in Hong Kong. The neoplasms are discovered incidentally by radiographic investigations and diagnosed by their classical histopathological features. All patients are noted to have underlying hyperglycaemia en passant. This preliminary observation provides insight into the pathogenesis of this specific type of renal neoplasm.\n                  <\/jats:p>","DOI":"10.3389\/fonc.2026.1903759","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:41:19Z","timestamp":1785300079000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Clinicopathological features of papillary renal neoplasm with reverse polarity: a report of four patients and literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"Raymond Yu","family":"O","sequence":"first","affiliation":[{"name":"Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong","place":["Hong Kong, Hong Kong SAR, China"]},{"name":"Division of Anatomical Pathology, Department of Pathology, Queen Mary Hospital","place":["Hong Kong, Hong Kong SAR, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony Wing Ip","family":"Lo","sequence":"additional","affiliation":[{"name":"Division of Anatomical Pathology, Department of Pathology, Queen Mary Hospital","place":["Hong Kong, Hong Kong SAR, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoi Lung","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Queen Mary Hospital","place":["Hong Kong, Hong Kong SAR, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anndiagpath.2025.152498","article-title":"Papillary renal neoplasm with reverse polarity shows benign behavior: Results from a 77-case clinicopathological and molecular study","volume":"80","author":"Lee","year":"2026","journal-title":"Ann Diagn Pathol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000001288","article-title":"Papillary renal neoplasm with reverse polarity: A morphologic, immunohistochemical, and molecular study","volume":"43","author":"Al-Obaidy","year":"2019","journal-title":"Am J Surg Pathol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.22465\/juo.244800440022","article-title":"Pathologic diagnosis of renal cell carcinoma in the era of the 2022 World Health Organization classification: Key points for clinicians","volume":"22","author":"Ahn","year":"2024","journal-title":"J Urol Oncol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3832","DOI":"10.3390\/cancers17233832","article-title":"Clinical and molecular characterization of KRAS-mutated renal cell carcinoma","volume":"17","author":"Lopez Sanmiguel","year":"2025","journal-title":"Cancers (Basel)"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.2337\/dc26-s002","article-title":"2. Diagnosis and classification of diabetes: Standards of care in diabetes-2026","volume":"49","year":"2026","journal-title":"Diabetes Care"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2015.09.014","article-title":"mTOR inhibitors and diabetes","volume":"110","author":"Verges","year":"2015","journal-title":"Diabetes Res Clin Pract"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2022.06.016","article-title":"The 2022 World Health Organization classification of tumours of the urinary system and male genital organs-part A: Renal, penile, and testicular tumours","volume":"82","author":"Moch","year":"2022","journal-title":"Eur Urol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.humpath.2023.09.011","article-title":"Papillary renal neoplasm with reverse polarity: a clinicopathologic study of 43 cases with a focus on the expression of KRAS signaling pathway downstream effectors","volume":"142","author":"Kim","year":"2023","journal-title":"Hum Pathol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2018.06.007","article-title":"Somatic bi-allelic loss of TSC genes in eosinophilic solid and cystic renal cell carcinoma","volume":"74","author":"Mehra","year":"2018","journal-title":"Eur Urol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-021-00896-6","article-title":"Germline and sporadic mTOR pathway mutations in low-grade oncocytic tumor of the kidney","volume":"35","author":"Kapur","year":"2022","journal-title":"Mod Pathol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2015.09.014","article-title":"Eosinophilic vacuolated tumor (EVT) of kidney demonstrates sporadic TSC\/MTOR mutations: next-generation sequencing multi-institutional study of 19 cases","volume":"35","author":"Farca\u015f","year":"2022","journal-title":"Mod Pathol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1016\/j.pathol.2023.11.013","article-title":"Non-coding RNA and gene expression analyses of papillary renal neoplasm with reverse polarity (PRNRP) reveal distinct pathological mechanisms from other renal neoplasms","volume":"56","author":"Nemours","year":"2024","journal-title":"Pathology"},{"key":"B13","doi-asserted-by":"publisher","first-page":"39","DOI":"10.3390\/ncrna7030039","article-title":"Functional role of miR-155 in the pathogenesis of diabetes mellitus and its complications","volume":"7","author":"Jankauskas","year":"2021","journal-title":"Noncoding RNA"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-2518","article-title":"Type 2 diabetes in relation to the risk of renal cell carcinoma among men and women in two large prospective cohort studies","volume":"41","author":"Graff","year":"2018","journal-title":"Diabetes Care"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1111\/cas.16157","article-title":"Decreased risk of renal cell carcinoma in patients with type 2 diabetes treated with sodium glucose cotransporter-2 inhibitors","volume":"115","author":"Chiu","year":"2024","journal-title":"Cancer Sci"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1038\/cddis.2014.445","article-title":"RAGE is essential for oncogenic KRAS-mediated hypoxic signaling in pancreatic cancer","volume":"5","author":"Kang","year":"2014","journal-title":"Cell Death Dis"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2025.111517","article-title":"Papillary renal neoplasm with reversed polarity: A case report of a rare renal tumor","volume":"133","author":"Kannan","year":"2025","journal-title":"Int J Surg Case Rep"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1598738","article-title":"Papillary renal neoplasm with reverse polarity: a case report and literature review","volume":"15","author":"Gonzalez","year":"2025","journal-title":"Front Oncol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1097\/01.ju.0001110068.14710.ff.12","article-title":"Papillary renal neoplasm with reverse polarity-a comparative study with CCPRCC, OPRCC, and PRCC1","volume":"129","author":"Wang","year":"2022","journal-title":"Hum Pathol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1739206","DOI":"10.21203\/rs.3.rs-6707949\/v1","article-title":"Papillary renal neoplasm with reverse polarity and renal clear cell carcinoma: a case report of image-pathology-molecular multidimensional diagnosis and nephron sparing surgery practice","volume":"15","author":"Liu","year":"2025","journal-title":"Front Oncol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e617","DOI":"10.1097\/RLU.0000000000006263","article-title":"A Rare Case of Bilateral Papillary Renal Neoplasm With Reverse Polarity on 18\u202fF\u2011FDG PET\/CT in Native Kidneys of a Transplant Recipient","volume":"51","author":"Gunes","year":"2026","journal-title":"Clin Nucl Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1668258","article-title":"Bilateral synchronous papillary renal neoplasm with reverse polarity and renal cell carcinoma with fibromyomatous stroma: a case report and review of the literature","volume":"15","author":"Chen","year":"2025","journal-title":"Front Oncol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1605192","article-title":"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","volume":"15","author":"Nithagon","year":"2025","journal-title":"Front Oncol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2025.04.012","article-title":"Papillary renal neoplasm with reverse polarity along with papillary adenoma in a non-functioning kidney: a rare report","volume":"57","author":"Vangapandu","year":"2025","journal-title":"Pathology"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1512036","article-title":"Synchronous papillary renal neoplasm with reverse polarity and membranous nephropathy: a rare case report","volume":"15","author":"Xing","year":"2025","journal-title":"Front Oncol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-025-04129-y","article-title":"Small papillary renal neoplasm with reverse polarity (\u2264 15 mm) may challenge the current diagnostic criteria of papillary adenoma","volume":"487","author":"Wang","year":"2025","journal-title":"Virchows Arch"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.33160\/yam.2025.05.008","article-title":"Two cases of papillary renal neoplasm with reverse polarity: Radiologic-pathologic correlation","volume":"68","author":"Gonda","year":"2025","journal-title":"Yonago Acta Med"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1159\/000545894","article-title":"Cytological features of the emerging entity papillary renal neoplasm with reverse polarity: A case report highlighting the relevance of fine-needle aspiration in renal masses","volume":"92","author":"Lobo","year":"2025","journal-title":"Pathobiology"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2024.12.017","article-title":"Papillary renal neoplasm with reverse polarity: CT and MR imaging characteristics in 26 patients","volume":"32","author":"Wen","year":"2025","journal-title":"Acad Radiol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2024.07.057","article-title":"Papillary renal neoplasm with reverse polarity: Two case reports","volume":"48","author":"Shao","year":"2024","journal-title":"Asian J Surg"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.21037\/tau-23-518","article-title":"Papillary renal neoplasm with reverse polarity: an observational study of histology, immunophenotypes, and molecular variation","volume":"13","author":"Han","year":"2024","journal-title":"Transl Androl Urol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1111\/pin.13417","article-title":"Papillary renal neoplasm with reverse polarity is biologically and clinically distinct from eosinophilic papillary renal cell carcinoma","volume":"74","author":"Castillo","year":"2024","journal-title":"Pathol Int"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1101268","article-title":"Rare papillary renal neoplasm with reverse polarity: A case report and review of the literature","volume":"13","author":"Tu","year":"2023","journal-title":"Front Oncol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"692","DOI":"10.5858\/arpa.2022-0156-oa","article-title":"Papillary renal neoplasm with reverse polarity: A clinical, pathologic, and molecular study of 8 renal tumors from a single institution","volume":"147","author":"Nova-Camacho","year":"2023","journal-title":"Arch Pathol Lab Med"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1011422","article-title":"Papillary renal neoplasm with reverse polarity with a favorable prognosis: Two cases report and literature review","volume":"12","author":"Yuzhi","year":"2022","journal-title":"Front Oncol"},{"key":"B36","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s13000-022-01235-2","article-title":"Papillary renal neoplasm with reverse polarity may be a novel renal cell tumor entity with low Malignant potential","volume":"17","author":"Yang","year":"2022","journal-title":"Diagn Pathol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1097\/pas.0000000000001773","article-title":"Papillary renal neoplasm with reverse polarity is often cystic: Report of 7 cases and review of 93 cases in the literature","volume":"46","author":"Wei","year":"2022","journal-title":"Am J Surg Pathol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.930296","article-title":"Papillary renal neoplasm with reverse polarity: A clinicopathological and molecular genetic characterization of 16 cases with expanding the morphologic spectrum and further support for a novel entity","volume":"12","author":"Shen","year":"2022","journal-title":"Front Oncol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.humpath.2022.06.016","article-title":"Papillary renal neoplasm with reverse polarity with a favorable prognosis should be separated from papillary renal cell carcinoma","volume":"127","author":"Liu","year":"2022","journal-title":"Hum Pathol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-019-0362-1","article-title":"Recurrent KRAS mutations are early events in the development of papillary renal neoplasm with reverse polarity","volume":"35","author":"Al-Obaidy","year":"2022","journal-title":"Mod Pathol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/j.anndiagpath.2021.151734","article-title":"Renal cell carcinomas with tubulopapillary architecture and oncocytic cells: Molecular analysis of 39 difficult tumors to classify","volume":"52","author":"Pivovarcikova","year":"2021","journal-title":"Ann Diagn Pathol"},{"key":"B42","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.humpath.2021.03.009","article-title":"Morphological, immunohistochemical, and genomic analyses of papillary renal neoplasm with reverse polarity","volume":"112","author":"Kiyozawa","year":"2021","journal-title":"Hum Pathol"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1111\/his.14320","article-title":"Clinicopathological and molecular characterisation of papillary renal neoplasm with reverse polarity and its renal papillary adenoma analogue","volume":"78","author":"Chang","year":"2021","journal-title":"Histopathology"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1111\/his.14084","article-title":"Frequent KRAS mutations in oncocytic papillary renal neoplasm with inverted nuclei","volume":"76","author":"Tong","year":"2020","journal-title":"Histopathology"},{"key":"B45","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1186\/s13000-020-01042-7","article-title":"Unilateral synchronous papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma: a case report with KRAS and PIK3CA mutations","volume":"15","author":"Lee","year":"2020","journal-title":"Diagn Pathol"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-019-0420-8","article-title":"Recurrent KRAS mutations identified in papillary renal neoplasm with reverse polarity-a comparative study with papillary renal cell carcinoma","volume":"33","author":"Kim","year":"2020","journal-title":"Mod Pathol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1903759\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:41:43Z","timestamp":1785300103000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1903759\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,29]]},"references-count":46,"alternative-id":["10.3389\/fonc.2026.1903759"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1903759","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,29]]},"article-number":"1903759"}}