L1CAM showed 100% sensitivity (10/10; 95% CI: 69.2–100%) and 100% specificity (44/44; 95% CI: 92.0–100%) in distinguishing LOT from the other eosinophilic renal neoplasms in this cohort (oncocytoma, E-chRCC, and EVT). Here, L1CAM is linked to oncocytic adenoma.