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Query: UMLS:C0016199 (flank pain)
 2,189 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinicopathologic features in a series of 21 chromophobe cell carcinomas are reviewed. Patients' ages ranged from 30 to 83 years (mean, 53 years), and the number of men and women was roughly equal. Major presenting complaints included hematuria, flank pain, and flank mass. All but two tumors were staged as tumor node metastasis (TNM) T2N0M0. Histologically, the carcinomas were composed of large cells with variably reticulated, translucent cytoplasm. The tumor cells could be divided into three types according to the extent and distribution of reticulated cytoplasm. Ultrastructurally, these reticulated areas were characterized by the presence of large numbers of microvesicles, which appeared to be unique to chromophobe cell carcinomas because ultrastructural examination of 20 clear cell carcinomas and six granular cell carcinomas failed to reveal similar structures. The origin of the vesicles appeared to be from saccular outpouchings from the outer mitochondrial membrane. Immunohistochemical studies revealed that all the tumors were variably positive for cytokeratins 8, 18, and 19, and epithelial membrane antigen but negative for vimentin. Flow cytometric DNA analysis of eight carcinomas revealed slightly hypodiploid cell populations in seven tumors. Of these, four also contained hyperdiploid cell populations. Follow-up (6-108 months) of 16 patients revealed all these patients to be alive and well. These findings further confirm the concept that chromophobe cell carcinoma is a special subtype of renal cell carcinoma in which the presence of microvesicles is a characteristic morphologic feature. Furthermore, loss of chromosomal DNA may also be a frequent, perhaps unique, feature of chromophobe cell carcinoma.
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PMID:Chromophobe cell carcinoma of the kidney. A clinicopathologic study of 21 cases. 757 86

The development of renal cell neoplasms ranging from adenoma to metastatic carcinoma is the most serious complication of acquired cystic kidney disease (ACKD). A comprehensive review of the pertinent literature shows that there is up to 50-fold increased risk of renal cell carcinoma in ACKD compared to the general population. The ACKD-associated renal cell carcinoma is seen predominantly in males, occurs approximately 20 years earlier than in the general population, and is frequently bilateral (9%) and multicentric (50%). Acquired cystic kidney disease-associated renal cell carcinoma is frequently asymptomatic (86%), but may be associated with bleeding, abrupt changes in hematocrit, fever, and flank pain or rarely with hypoglycemia, hypercalcemia, or metastases at presentation. Computed tomography seems to provide a better diagnostic yield than sonography or magnetic resonance imaging; nevertheless, large (up to 8 cm) tumors not visualized by any imaging techniques have been reported. It is generally agreed that there is a need for regular screening of symptomatic ACKD patients for early detection of renal cell carcinoma; however, whether screening is needed for asymptomatic patients remains controversial. Nephrectomy is indicated for tumors larger than 3 cm. Management for tumors smaller than 3 cm with persistent symptoms, such as back pain or hematuria, remains controversial, but nephrectomy may be recommended since many of these tumors turn out to be unequivocal renal cell carcinoma. Asymptomatic tumors smaller than 3 cm should be serially screened, and tumor enlargement may be an indication for nephrectomy. Acquired cystic kidney disease-associated renal cell carcinoma accounts for approximately 2% of deaths in renal transplant patients. A median length of survival of approximately 14 months and a 5-year survival rate of 35% are comparable to the same data for renal cell carcinoma in the general population. Successful renal transplant probably decreases the risk of renal cell carcinoma in ACKD patients, but this preliminary observation needs confirmation. The development of ACKD-associated renal carcinoma is a continuous process with evolving phenotypic expression, including damaged renal tubule, simple cyst, cyst with atypical lining, adenoma, and, finally, carcinoma. The pathogenesis of this continuous process is not entirely known, but growth factor-induced compensatory growth of tubular epithelium initiated by the changes of end-stage kidney disease, and probably perpetuated by activation of proto-oncogenes, seems to be the most significant factor.
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PMID:Renal neoplasm in acquired cystic kidney disease. 761 Dec 40

A 48-year-old male experienced sudden pain in the right flank and macrohematuria with subsequent repeated episodes of painless macrohematuria. In the radiological work-up, CT was interpreted as inflammatory enlargement of the right kidney and MRI diagnosed renal vein thrombosis. There was some suspicion that there might be a malignancy. Five months later the patient had to be admitted to the hospital, because of increasing flank pain, desiccation and general signs of inflammatory disease. Radiological changes compatible with pulmonary metastases were found. Biopsy of enlarged mediastinal lymph nodes revealed undifferentiated carcinoma. Because of the expression of Cytokeratin primary urothelial carcinoma was suspected. The patient then deteriorated rapidly. No further specific therapy could be carried out. Death was chiefly caused by respiratory insufficiency 5 months after the first episode of pain and 1 month after admission. Autopsy revealed a poorly differentiated urothelial carcinoma of the right renal pelvis, with extensive carcinomatous angiomatosis and metastases to the left kidney, lungs, and regional and mediastinal lymph nodes. Independently of the carcinoma, both kidneys also showed interstitial nephritis, papillary necrosis and capillarosclerosis, compatible with analgesic-user kidney ("phenacetin kidney") in the absence of a corresponding history.
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PMID:[Explosive metastasis of a cancer of the kidney pelvis in analgesic kidney]. 815 79

Urinary tract infection in the female patient is not an uncommon finding. Flank pain associated with urinary tract infection is usually due to calculus disease or pyelonephritis. In patients with history of breast carcinoma, metastasis to the periureteral area with resulting obstruction should be considered. The incidence of metastatic breast carcinoma presenting in this fashion is as high as 7.8 per cent. This case shows a patient with metastatic lobular carcinoma of the breast with ureteral obstruction, causing flank pain and recurrent urinary tract infection. This report emphasizes the importance of long-term follow-up in patients with history of breast cancer, especially invasive lobular carcinoma, and the high degree of suspicion required to diagnose and institute proper therapy.
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PMID:Carcinoma of the breast metastatic to the ureter presenting with flank pain and recurrent urinary tract infection. 875 67

ACKD is characterized by the development of many fluid-filled renal cysts and sometimes neoplasms in the kidneys of individuals with chronic renal failure but without a history of hereditary cystic disease. The condition is seen mainly in dialysis patients, but often begins in patients with ESRD before dialysis is started. Most patients with ACKD are asymptomatic, but the disorder may be associated with such serious complications as retroperitoneal hemorrhage and metastatic renal cell carcinoma. The diagnosis of ACKD and its complications is best achieved by CT scanning, although US and MR imaging may be useful in evaluation, particularly in patients not treated with dialysis. Cyst hemorrhage is common in ACKD and may cause flank pain and hematuria. Hemorrhagic cysts may be recognized by their CT scan, sonographic, or MR imaging features. Hemorrhagic cysts may rupture into the perinephric space causing large perinephric hematomas. These can usually be treated-conservatively. Patients with ACKD, particularly those treated with dialysis, have an increased risk of renal cell carcinoma. Renal cell carcinoma may also develop in the native kidneys of renal transplant recipients with good graft function many years after transplantation. Annual imaging of the native kidneys of all dialysis patients or of transplant recipients for the development of carcinoma is not justified, however, because it has not been shown to have a significant effect on patient outcome. Screening may, however, be useful in selected dialysis patients with good general medical condition and who have known risk factors for renal cell carcinoma including prolonged dialysis, large kidneys, ACKD, and male gender. Screening of the native kidneys of transplant recipients may be performed when they are referred for US evaluation of the renal allograft.
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PMID:Acquired cystic kidney disease. 878 91

Carcinosarcoma of the adrenal gland is an extremely rare variant of adrenocortical carcinoma, characterized by a biphasic pattern of carcinoma and sarcoma-like components. We report a case of adrenal carcinosarcoma occurring in a 61-year-old Korean man who presented with right flank pain of one month duration radiating to the back and right iliac crest. The tumor measured 12 x 12 x 7 cm and adhered to the liver and right upper pole of the kidney. The carcinomatous component of the tumor showed polygonal cells in a broad anastomosing trabecular pattern with delicate slit-like vascular channels; the sarcomatous component showed uniform spindled cells in a fascicular pattern. Both the carcinomatous and sarcomatous portions of the tumor were positive for pan-cytokeratin, and vimentin stained only the sarcomatous areas.
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PMID:Adrenal carcinosarcoma--a case report. 928 40

Renal Cell Carcinoma is the third most common malignoma in urology. Only little is known about the etiology and risk factors; the age peak lies at 60 and twice as many men than women are affected. The clinical picture presents with a wide spectrum. Over one third of all tumours are detected accidentally by ultrasound or computed tomography in asymptomatic patients. Most common symptoms are hematuria and flank pain, the classical trials including in addition a palpable mass is rare and by mo means an early symptom. Paraneoplastic syndromes include unspecific (increased blood sedimentation rate, weight loss, fever) and endocrine symptoms (hypertension, polyglobulia, hypercalcemia). Diagnosis is based on imaging procedures. By means of sonography renal cysts may be separated from solid, space-occupying tumors. For the latter CT plays a decisive role for staging, therapeutic planning and prognosis. Further radiologic investigations (angiography, MRI) are indicated only in special situations. Rarely a biopsy is necessary for the distinction between renal cell carcinoma and metastases of other primary tumors. The only curative treatment of localized carcinoma is radical nephrectomy. Partial resection is indicated in cases of a single kidney, bilateral tumors and possibly also for tumors smaller than 4 cm in diameter. Radiotherapy is only initiated for palliation of painful skeletal metastases. In case of distant metastases--mainly pulmonary--nephrectomy should only be performed if systemic treatment is planned or if local complaints (pain, hematuria leading to anemia) exist. Chemotherapeutic drugs have no influence on survival. The effect of gestagens on life quality is questionable. Adoptive immunotherapy with cytokines (Interferon-alpha, interleukin-2) appears most promising. These substances, however, not yet been introduced into routine therapy should only be used in prospective studies. Furthermore, renal cell carcinoma is a potential candidate for gene therapy. After tumor nephrectomy follow-up investigations should be performed twice a year, because of the possibility of curative surgical treatment of late solid metastases. Prognosis of tumors restricted to the organ is good. Five year survival after operation is about 90%. However, is distant metastases exist already at the time of diagnosis 5 year survival drops to less than 10%.
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PMID:[Renal cell carcinoma--a current review]. 931 11

We report a case of a sonographically-detected impalpable embryonal cell carcinoma with bulky retroperitoneal metastases. A 34-year-old man, who presented with left flank pain, was presumed to have an extragonadal retroperitoneal germ cell tumor. Scrotal sonography revealed a hypoechoic lesion, 7 mm in diameter, which was histologically diagnosed as a primary embryonal cell carcinoma. Evidence suggested that the primary tumor had grown slowly, as the tumor was well encapsulated. This case suggests that some extragonadal germ cell tumors arise from a primary testicular cancers, and that successful treatment of these tumors should include consideration that they may have arisen as a primary testicular mass.
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PMID:Sonographically-detected impalpable testicular cancer with retroperitoneal bulky metastases: a case report. 935 63

A 26-year-old female, who had been treated for cervical carcinoma, presented with high fever and right flank pain. A right renal abscess was initially suspected from the clinical symptoms and diagnostic imaging. However, pathologic findings for the right kidney revealed squamous cell carcinoma, which was consistent in type with the original cervical carcinoma. Demonstration of human papillomavirus 16 in tissues from both the renal tumor and the cervical carcinoma confirmed that the right kidney carcinoma was a metastasis from the cervical carcinoma. The role of interleukin-6 in occurrence of the unexplained fever is discussed.
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PMID:Metastatic cervical carcinoma mimicking kidney abscess. 971 49

We herein report a rare case of peripelvic extravasation due to peritoneal dissemination of pancreatic carcinoma. A 75-year-old female with left flank pain was admitted. Computed tomographic scan demonstrated a huge urinoma medial and posterior to the left kidney, and an irregular mass around the left lower ureter. Retrograde pyelography showed complete ureteral obstruction. The probable diagnosis was spontaneous peripelvic extravasation due to left ureteral tumor or ovarian tumor. Laparotomy revealed a tumor involving the body and tail of the pancreas and some disseminated tumors in the retroperitoneum. Pathological diagnosis was metastatic carcinoma of the pancreas. Malignant tumors in the digestive organs should be taken into consideration in the differential diagnosis of peripelvic extravasation.
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PMID:[Peripelvic extravasation due to peritoneal dissemination of pancreatic carcinoma: a case report]. 989 27


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