BACKGROUNDThere is an increased incidence of renal tumours every year in the last three decades, RCC being the most common. There is little published data on the spectrum of renal tumours in India, especially Southern parts like Kerala. Hence, this study is undertaken to analyse the relative frequencies of different types of renal tumours and their histopathological characteristics.The aim of the study is to find out the mean age of presentation, mode of presentation and gender predominance of renal tumours, the histopathological subtype of renal tumours and microvascular invasion. MATERIALS AND METHODSThis was a descriptive study carried out in the Department of Pathology, Government Medical College, Kottayam. 51 nephrectomy specimens of renal neoplasm received during the period of two years were studied. Statistical analysis was done using SPSS version 16. RESULTSAmong 51 nephrectomy specimens of renal neoplasm, 90.2% (46/51 cases) were of malignant tumours. Of 46 malignant cases 31/51 cases were of clear cell carcinoma, 7/51 cases were of papillary carcinoma, 5/51 cases were of chromophobe carcinoma, 1/51 were of multilocular cystic RCC and 2/51 were of unclassified RCC. Of 5 benign cases (9.8%) 2/51 were of oncocytoma, 1/51 were of solitary fibrous tumour, 1/51 were of clear cell sarcoma and 1/51 were of angiomyolipoma. Majority of renal neoplasms (90.2%) were RCC, seen predominantly in middle aged males (mean age is 52.41 years). They mostly presented with symptoms of abdominal pain (37.2%) and mass (31.3%). The classical symptom triad (macroscopic haematuria, palpable tumour and pain) was less commonly seen (8.7%). Clear cell carcinoma was the most common histological type of renal tumours (60.7%) and also had the most number of capsular (60%) and renal sinus invasion (72%), which may indicate bad prognosis. As the size, stage/ grade of the tumour increased, the symptoms did not increase. Therefore, relative paucity of symptoms does not mean that the tumour has not made much progression/ is completely curable/ resectable. CONCLUSIONIncidental tumours being in the lower stages and lower nuclear grades indicate that early detection of renal neoplasms by radiological screening may have some value. However, large scale case control studies are needed to make accurate analysis of renal neoplasms including the measurement of cancer specific survival and prognosis. The incidence rates of RCC have risen steadily each year during the last three decades in most parts of the world with an average increase of 2% to 3% per year. 1 The increased incidence is primarily due to two reasons. One is the increased detection via radiological methods like USG and CT. 'Financial or Other Competing Interest': None. Submission 24-10-2017, Peer Review 21-11-2017, Acceptance 27-11-2017, Published 11-12-2017. Corresponding Author: Dr. Lillykutty Pothen, Kaniankunnel House, Gandhinagar P. O, Kottayam. E-mail: glamskan@gmail.com DOI: 10.14260/jemds/2017/1453 Another reason is the increased prevalence of risk factors l...