Interestingly, patient’s left kidney showed, besides PLNRs, some cystic lesions characterized by an epithelium reactive for TFE3, which is a marker for a specific RCC subtype, primarily occurring in children and young adults and characterized by Xp11.2 translocations leading to different type of TFE3 gene fusions13. This evidence concerns the gene TFE3 and renal cell adenocarcinoma.