Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016199 (flank pain)
 2,189 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Genitourinary tuberculosis (TB) is the second most common form of extrapulmonary TB after peripheral lymphadenopathy. We report the case of a 44-year-old woman referred for hydronephrosis discovered on ultrasound performed due to flank pain. Contrast computed tomography (CT) scan demonstrated a well-circumscribed cystic mass with enhancing septations at the inferior pole of the right kidney, concerning for malignancy. Following extirpative surgery, she was diagnosed with renal TB.
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PMID:An unusual presentation: renal tuberculosis. 1911 36

We report a case of colorectal cancer with metastasis to the upper urinary tract. A 56-year-old man had left flank pain. Ultrasonography and computed tomographic (CT) examination demonstrated left hydronephroureter and a soft-tissue structure within the left ureter. Urinary cytology of the left ureter showed class IIIb. We diagnosed him with ureteral cancer and performed left nephroureterectomy. Microscopic examination demonstrated adenocarcinoma located in ureteral and pelvic wall, especially in blood vessels, with intact mucosa and similar to adenocarcinoma of colon cancer. Therefore metastatic upper urinary tract tumor was suspected. Barium enema and positron emission tomography-CT demonstrated sigmoid colon cancer. Biopsy specimen of colon cancer demonstrated adenocarcinoma, which was consistent with the ureteral tumor. Finally we diagnosed him with metastatic upper urinary tract tumor of sigmoid colon cancer.
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PMID:[A case of upper urinary tract metastases from sigmoid colon cancer]. 1958 67

The vast majority of patients with metastatic prostate cancer present with bone metastases and high prostate specific antigen (PSA) level. Rarely, prostate cancer can develop in patients with normal PSA level. Here, we report a patient who presented with a periureteral tumor of unknown primary site that was confirmed as prostate adenocarcinoma after three years with using specific immunohistochemical examination. A 64-year old man was admitted to our hospital with left flank pain associated with masses on the left pelvic cavity with left hydronephrosis. All tumor markers including CEA, CA19-9, and PSA were within the normal range. After an exploratory mass excision and left nephrectomy, the pelvic mass was diagnosed as poorly differentiated carcinoma without specific positive immunohistochemical markers. At that time, we treated him as having a cancer of unknown primary site. After approximately three years later, he revisited the hospital with a complaint of right shoulder pain. A right scapular mass was newly detected with a high serum PSA level (101.7 ng/ml). Tissues from the scapular mass and prostate revealed prostate cancer with positive immunoreactivity for P504S, a new prostate cancer-specific gene. The histological findings were the same as the previous pelvic mass; however, positive staining for PSA was observed only in the prostate mass. This case demonstrates a patient with prostate cancer and negative serological test and tissue staining that turned out to be positive during progression. We suggest the usefulness of newly developed immunohistochemical markers such as P504S to determine the specific primary site of metastatic poorly differentiated adenocarcinoma in men.
Cancer Res Treat 2009 Mar
PMID:Cancer of unknown primary finally revealed to be a metastatic prostate cancer: a case report. 1968 71

We present here a patient with acute lymphoblastic leukemia (ALL) and who developed infective endocarditis during induction chemotherapy with prednisolone, L-asparaginase (Leunase), vincristine and adriamycin. The patient did not have a history of a central venous catheter. Sharp flank pain and fever occurred on the 25(th) day of induction chemotherapy. In addition, a renal infarct and movable vegetations on the mitral valve were detected on the abdominal computed tomography (CT) and echocardiography. S. aureus was identified in the cultured blood. While the patient achieved remission, follow-up echocardiography revealed the vegetation had increased in size and an abscess pocket had developed despite the antibiotics and heparin therapy. Consequently, ten days after the diagnosis of infective endocarditis, a successful mitral valvuloplasty was performed without complications. The patient is currently on maintenance chemotherapy while in remission.
Cancer Res Treat 2008 Sep
PMID:Staphylococcal endocarditis presenting with a renal infarct in a patient with acute lymphoblastic leukemia. 1968 23

A 20-year-old African American male presented with a history of left flank pain and passing of light pink urine. Medical history included sickle cell trait. Urine analysis was positive for protein and blood. Metabolic profile, autoantibody screen, and complement levels were normal. Hemoglobin electrophoresis revealed an 41.8% HbS diagnostic of sickle cell trait. Creatinine clearance was normal and proteinuria was nonnephrotic. A noncontrast computed tomography (CT) scan showed left proximal hydronephrosis. Urology follow-up was arranged and the differential included renal papillary necrosis, or renal cyst rupture. He presented 3 months later with sudden onset left flank pain and gross hematuria. Serum creatinine was 1.8 mg/dL. Computed tomography scan with contrast revealed innumerable lung lesions, an enlarged heterogenously enhancing left kidney, and retroperitoneal adenopathy. Ultrasound revealed an obstructed left collecting system and a 14-cm enlarged left kidney with no discrete mass. Testicular markers/ultrasound, upper/lower endoscopies were normal. Lung biopsy revealed poorly differentiated adenocarcinoma positive for cytokeratin 7. Renal, sarcoma, and gastrointestinal markers were negative. By exclusion, it appeared that the patient had a carcinoma of unknown primary. However, with the clinical and personal history, a diagnosis of renal medullary carcinoma (RMC) was made. RMC is a rare and highly malignant tumor that should always be included in the differential of a patient with sickle cell disorder and hematuria. Renal biopsy typically fails to sample the renal medulla and radiologic findings might not raise the suspicion of a renal tumor. Thus, clinical suspicion must always be high in order to preserve the patient's only chance of prolonged survival.
Clin Genitourin Cancer 2009 Aug
PMID:Adenocarcinoma of unknown primary in a 20-year-old African American male. 1969 25

We report a rare case of spontaneous pneumomediastinum due to perforation of sigmoid cancer in a patient suffering from Vogt-Koyanagi-Harada syndrome and temporal arteritis, two rare diseases. This patient, who generally receives corticosteroid and methotrexate therapy, was admitted to hospital with vague abdominal and left flank pain, urinary disorders and low grade fever one day prior to admission. Initial evaluation including X-ray and laboratory tests was normal. Several hours later a repeat chest X-ray showed pneumomediastinum. Chest and abdominal Computed Tomgraphy were performed because of worsening abdominal pain, and revealed a perforated sigma due to carcinoma.
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PMID:Pneumomediastinum as a presenting symptom of perforated sigmoid cancer: a case report. 1982 48

A 34-year-old female patient visited a nearby hospital with a chief complaint of right flank pain and decreased weight. Computed tomography showed a right retroperitoneal mass 10 cm in diameter on the right kidney, displacing the liver and the right kidney. The patient was referred to Kawasaki Municipal Hospital for further evaluation. The mass was suspected to be chronic expanding hematoma or neurogenic tumor of renal capsule origin. A retroperitoneal tumorectomy was performed with a right subcostal incision. A mass was noted in the smooth capsule. The mass was easily removed from the right renal capsule. However, there was significant adhesion between the mass and the peritoneum as well as the liver capsule. Therefore, a partial hepatectomy was needed for complete resection of the mass including the capsule. A fibrous capsule was noted and most of the mass was blood clot-like tissue. The histopathological diagnosis was chronic expanding hematoma with no malignancy. A retroperitoneal chronic expanding hematoma has very rarely been reported.
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PMID:[A case of chronic expanding hematoma in retroperitoneal space]. 1992 43

Wilms Tumor (WT) is a very rare malignancy in adults representing 1% of all renal neoplasms. It is however the most common renal tumor of children and adult patients are treated like pediatric cases. Bilateral tumors occur in 5% of adult cases. The typical presenting features are asymptomatic abdominal mass (most common), hematuria, pain, fever, and hypertension. As clinical presentation of WT is similar to that of renal cell carcinoma (RCC), it tends to be an unsuspected pathological diagnosis in most cases. The diagnosis of the tumor needs positive sonographic and computed tomography (CT) findings with histopathological confirmation. Prognosis of adult WT is relatively poor and resistant to chemotherapy. We present a case of wilms tumor in a 68 years old male patient with right sided non tender abdominal mass and occasional flank pain. The patient was normotensive but hematuric and radiological findings suggested right renal mass with enlarged lymph node and histopathological analysis revealed nephroblastoma associated with lymph node metastases.
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PMID:Wilms tumor in adult. 2039 30

Xanthogranulomatous cystitis is a rare, benign, chronic inflammatory disease of the bladder, mimicking malignancy with unknown etiology. Herein, we report a 57-year-old man who presented with pollakiuria, nocturia, dysuria, left flank pain, and a palpable mass on the right lower abdomen. Computerized tomography demonstrated an obstructing 10-mm stone in the lower third of the left ureter and a 6-cm solid mass on the right at the anterolateral wall of the bladder. The mass presented local perivesical invasion at the anterolateral side. Cystouretroscopy revealed a mass protruding into the bladder cavity with edematous smooth surface. Frozen section analysis of the partial cystectomy specimen could not rule out malignancy. Therefore, radical cystoprostatectomy and ureterolithotomy were performed. Histologically, fibrosis, numerous plasma cells, eosinophils, and, immunohistochemically, CD68-positive epithelioid and foamy macrophages were detected. Localized prostatic adenocarcinoma was also found. The present case of xanthogranulomatous cystitis is the 23rd to be reported in the world literature.
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PMID:Xanthogranulomatous cystitis: a challenging imitator of bladder cancer. 2060 75

A 53-year-old man presented with right flank pain for 6 days. Computerized tomography revealed a 3 cm long segment of ureteral narrowing with wall thickening and hydronephrosis, suspicious for ureteral cancer. Under the clinical diagnosis of ureteral carcinoma a right nephroureterectomy was performed. The wall of the distal ureter, 2.5 cm from the bladder cuff, had a luminal-narrowing, firm mass-forming lesion with abrupt transition from the adjacent ureter. Histologically, the resected ureteral mass showed transmural fibrosing, chronic inflammation with numerous plasma cells, epithelioid granulomas, and obliterative phlebitis. Histological findings were consistent with idiopathic segmental ureteritis (ISU) with differential diagnoses of IgG4-related sclerosing disease, including lymphoplasmacytic inflammatory pseudotumor (IPT) and idiopathic retroperitoneal fibrosis. IgG4 immunostaining in this case was barely positive, excluding the possibility of IgG4-related IPT. Although the majority of luminal obliterated segmental lesions of the ureter are neoplastic in nature, non-neoplastic inflammatory processes as seen in this case may occur in the ureter, causing diagnostic confusion with true neoplasms. Herein we report a rare case of ISU that was clinically misdiagnosed as malignancy preoperatively. ISU of the current case may be an IgG4-unrelated subtype of IPT.
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PMID:Idiopathic segmental ureteritis, misdiagnosed as ureteral cancer preoperatively: a case report with literature review. 2109 36


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