Primitive neuroectodermal tumor of the kidney (PNET) is a very rare and highly aggressive tumor commonly seen in young adolescents. These tumors are rare in patients over 40 years. Reports of renal PNET in elderly patients over 60 years are even rarer.We report three cases of renal PNET in adult patients diagnosed over a period of three years. Among the three patients, two were above 60 years of age and the third patient was a 39-year-old male. All the three patients had extensive venous thrombosis at the time of presentation. One of the patients succumbed to death in the immediate post-operative period and the other two received chemotherapy.Renal PNET owing to its rare occurrence in middle-aged and elderly poses a diagnostic challenge to the pathologist. The clinical and radiological findings have limitations in the accurate diagnosis. Thorough morphological evaluation along with immunohistochemistry and cytogenetic analysis help in arriving at a correct diagnosis. An accurate diagnosis is crucial for the initiation of proper treatment.
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