Papillary renal cell carcinoma (PRCC) is a malignant, heterogeneous tumor originating from renal tubular epithelial cells of the kidney, which comprises approximately 10-15% of all kidney neoplasms. Based on its morphological features, PRCC can be classified into two main subtypes, which are type 1 (basophilic) and type 2 (eosinophilic).As with other types of renal cell cancer, most cases of PRCC are discovered incidentally without showing specific signs or symptoms of cancer. In advanced stages, hematuria, flank pain, and abdominal mass are the three classic manifestation. While a complete list of the causes of PRCC remains unclear, several risk factors were identified to affect PRCC development, such as genetic mutations, kidney-related disease, environmental and lifestyle risk factors. For pathogenesis, type 1 PRCC is mainly caused by MET gene mutation while type 2 PRCC is associated with several different genetic pathways. For diagnosis, PRCC is detectable through computed tomography (CT) scans or magnetic resonance imaging (MRI), which commonly present a small homogeneous hyposvascular tumor. Nephrectomy or partial nephrectomy is usually recommended for PRCC treatment, often accompanied with several targeted molecular therapies to inhibit metastatic spread. PRCC patients are predominantly male with a mean age of 52–66 years. When compared to conventional clear cell renal cell carcinoma (RCC), the prognosis of non-metastatic PRCC is more favorable, whereas a relatively worse outcome was reported in patients with metastatic disease. Globally, the incidence of PRCC ranges between 3,500 to 5,000 cases, while it greatly varies depending on gender, age, and race/ethnicity.
A pilon fracture,  is a fracture of the distal part of the tibia, involving its articular surface at the ankle joint. Pilon fractures are caused by rotational or axial forces, mostly as a result of falls from a height or motor vehicle accidents. Pilon fractures are rare, comprising 3 to 10 percent of all fractures of the tibia and 1 percent of all lower extremity fractures, but they involve a large part of the weight-bearing surface of the tibia in the ankle joint. Because of this, they may be difficult to fixate and are historically associated with high rates of complications and poor outcome.Pilon is the French word for "pestle" and was introduced into orthopedic literature in 1911 by pioneer French radiologist Étienne Destot. Classification
Pilon fractures are categorized by two main X-ray schemes, Ruedi-Allgower classification system. and Müller AO Classification of fractures. Treatment
The treatment of pilon fractures depends on the extent of the injury. This includes the involvement of other bones such as the fibula and the talus, involvement of soft tissue, and the fracture pattern. Treatment strategies and fixation methods used include internal and external fixation, as well as staged approaches, with the aim of reducing the fracture, reconstructing the involved bones and restoration of articular surface congruence, with minimal insult to soft tissues. Appropriate wound management is important to reduce the high rate of infectious complications and secondary wound healing problems associated with open pilon fractures.