Investigating Renal Papillary Adenoma: Identifying the Associated Conditions Through the Vigilant Lens of the...

Renal papillary adenoma (RPA) is a rare benign tumor that is usually asymptomatic and incidentally detected. Although typically benign and of low malignant potential, close monitoring and further investigation is warranted due to the potential association with renal cell carcinoma and other associated conditions as per the present literature. We performed a clinicopathological evaluation of incidentally detected renal papillary adenomas to ascertain features having a prognostic impact along with the systematic review of literature. All cases of incidentally detected RPA of the kidney from January 2019 to December 2022 were assessed for size, site of adenomas, clinical features, associated conditions, clinical diagnosis, and a number of adenomas. Each feature was noted and correlated with the associated conditions of the patient and prognosis. We received a total of 62 nephrectomies, in the Department of Pathology, AIIMS Rishikesh, for non-functioning kidneys from January 2019 to December 2022, four cases exhibit incidentally detected renal papillary adenoma. Medical renal biopsies received during the period were 330 in number and only one case shows renal papillary adenoma along with IgA nephropathy and focal segmental glomerulosclerosis (FSGS) lesion. The association of both entities is unclear in the medical literature and is a rare finding. Two cases of chronic pyelonephritis demonstrate multiple adenomas of varying sizes and one was associated with hepatitis B virus infection. Our study outlines histomorphology spectrum of incidentally detected RPA and emphasizes its frequent occurrence in patient undergoing nephrectomies for non-functioning end-stage kidney diseases and rare association of IgA nephropathy. Limitation of the study was a small number of cases with follow-up.