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)

A 60-year-old man was referred to our institution with the diagnosis of sarcoidosis. Because of several months' complaint of right flank pain and weight loss, the patient had consulted his local physician. After an extensive workup revealed only cholelithiasis, he underwent a cholecystectomy for presumed chronic cholecystitis. At the time of operation, biopsy of several liver nodules and peripancreatic nodes revealed noncaseating granulomas, consistent with sarcoidosis. On initial examination at our institution, the patient had microhematuria. A chest roentgenogram demonstrated multiple pulmonary nodules, an abdominal computed tomographic scan showed an indeterminate left renal mass, and magnetic resonance imaging of the spine revealed abnormal signals in the body of T-12. Open-lung biopsy showed an adenocarcinoma with clear cell features, likely of renal origin. The patient was diagnosed as having a metastatic renal carcinoma associated with a sarcoidlike tissue reaction. Although noncaseating granulomas have been reported in association with other malignant lesions, to our knowledge this is the first report of such an association with renal carcinoma. In addition, this case illustrates several points. First, sarcoidosis is a multisystem disorder with protean extrapulmonary manifestations. In fact, all our patient's findings could have been attributed to sarcoidosis. Second, noncaseating granulomas occur with many types of processes, including infections, chemical exposures, and, as in this case, neoplasms. Thus, noncaseating granulomas are not pathognomonic for sarcoidosis. Third, sarcoidosis is a clinical diagnosis that cannot be based on histologic findings alone.
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PMID:Renal cell carcinoma associated with sarcoidlike tissue reaction. 223 2

A 41-year-old miller undergoing hemodialysis for 9 years presented with recurrent episodes of asymptomatic gross hematuria of a 7 years' duration and left flank pain with slight fever of a four months' duration. CT scans revealed bilateral acquired cystic disease of the kidney (ACDK) and a mass (phi 4 cm) in the medial portion of the left kidney, which was angiographically a hypovascular tumor. Cystoscopic examination revealed multiple papillary tumors arising from the entire bladder wall. These findings suggested that the renal mass was a renal pelvic tumor. Bilateral nephroureterectomy with left paraaortic lymph nodes dissection and radical cystectomy were carried out, followed by urethrectomy two weeks later. Histologically, multiple papillary transitional cell carcinomas with G2 greater than G3 anaplasia were found in the left renal pelvis, the lower portion of the left ureter and the bladder. The tumors were predominantly superficial, although the renal pelvic one focally invaded into the muscular layer. Lymph node metastasis and renal cell carcinoma were not recognized. Postoperative course was uneventful with normal blood pressure, though anemia was slightly progressive. He has been free of disease for six months.
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PMID:[Multiple urothelial cancers accompanied by acquired cystic disease of the kidney in a long-term hemodialysis patient]. 240 87

A case of renal cell carcinoma with multiple lung metastases successfully treated with interferon (IFN) following nephrectomy is reported. A 46-year-old man consulted our institute complaining of left flank pain for 3 months on June 18, 1983. Macroscopic hematuria consisting of blood clot had also been found 1 week before. For a diagnosis of left renal carcinoma with multiple lung metastases, he was admitted. After total nephrectomy, 30 x 10(6) units per day of natural IFN-beta were administered intravenously every other day for 2 months (total dose; 269 x 10(6) units). One of the pulmonary lesions disappeared, but another increased in size and a new lesion was also found. Therefore, this trial was evaluated to be progression. Thereafter, he was treated with 600 mg/day of carmofur (HCFU) and was in a stable condition. As his lung lesions progressed at 11 months after nephrectomy, 9 x 10(6) units/day of recombinant IFN-beta were additionally administered 5 days a week for 4 weeks. When the treatment was completed (total dose; 180 x 10(6) units), the pulmonary lesions disappeared. The complete response lasted for 9 months. However, on May, 1985, bone metastasis to lumbar vertebra was found and he died on November 4, 1985 without any evidence of relapse at lung field.
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PMID:[A case of renal cell carcinoma with lung metastases successfully treated by interferon-beta]. 273 68

A case of bilateral renal angiomyolipoma without tuberous sclerosis is reported. A 49-year-old woman was admitted to the general practitioner with a sudden onset of severe left flank pain. An excretory urogram and ultrasonogram revealed an enlargement of the left kidney. She was subsequently referred to our clinic for further investigation and treatment. Computed tomographic scan and magnetic resonance imaging using Tl-weighted image showed several tumors with a fatty, dense area in the bilateral kidney. An arteriogram demonstrated a hypervascular renal mass with aneurysms in her left kidney. Diagnosis of bilateral renal angiomyolipoma was confirmed by percutaneous needle biopsy. Superselective embolization of the tumor was successfully performed, preserving normal renal tissue. Gelatin sponges containing Carboquone (CQ sponge) were used as embolic material. Angiomyolipoma has become relatively easy to diagnose by CT, ultrasound, MRI and so on. However, there are some cases of angiomyolipoma which are indistinguishable from renal cell carcinoma using these modes of testing. Therefore, in selecting a conservative management, we indicated that percutaneous biopsy or open biopsy should be done to confirm the results of the above procedures. Moreover, therapeutic embolization for angiomyolipoma was concluded to be very useful.
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PMID:[Therapeutic embolization of renal angiomyolipoma: a case report]. 280 11

Though renal cell carcinoma is a fairly common disease, it is extremely rare to encounter a case providing a resected mass as large as over 2,000 g in weight. We report a case in which a giant 2,200 g tumor was resected after renal arterial embolization and interferon treatment for reduction of its size. A forty-three-year-old woman was first seen at a certain hospital with a chief complaint of fever and right flank pain. Under suspicion of right renal tumor, nephrectomy by extraperitoneal flank incision was attempted. However, the tumor was too large to be resected. After transfer to our department, she was treated by renal arterial embolization with absolute ethanol and steel coil and by the administration of interferon (rIFN-alpha A). As the tumor shrank to 77% of its original size on CT measurements and became mobile, transperitoneal nephrectomy was performed. The resected mass was as large as 12 x 12 x 21 cm. Pathologically, it was a clear cell type tumor showing mucinous degeneration and hyaline degeneration of tumor cells. Interferon used amounted to as high as 864 x 10(6) units, but no particular side effect occurred. No recurrence has been detected so far.
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PMID:[Giant renal cell carcinoma: a case report]. 280 77

A 20-year-old female, who was one of identical twins, was transferred from an another hospital for further therapy of a right renal tumor. There was no history of hematuria, flank pain. Routine laboratory studies were within the normal range. On excretory urogram, the tumor, 7 x 9 cm in diameter, was demonstrated in lower pole of the right kidney. A selective renal arteriography revealed that the central area of the tumor was rather hypovascular, but, some neovascularity was seen in the peripheral area. Pedal lymphography, chest X-ray and bone survey showed normal findings. A right nephrectomy was carried out. Grossly, the tumor in the lower pole of the kidney was well demarcated by a pseudocapsule and had massive necrotic areas. Pathological sections revealed a granular cell adenocarcinoma of the right kidney. No extension into the peripheric fat was present. The patient remains well and free of recurrent tumor one year post-operatively. We discussed the diagnosis and prognosis of renal cell carcinoma in young adults in the literature.
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PMID:[Adenocarcinoma of the kidney in a 20-year-old female]. 319 10

The success of cancer therapy depends on the destruction of all viable cancer cells in the primary site, as well as in metastatic areas. Surgery alone can do little for the patient whose tumor has produced distant involvement except in those situations where surgical excision, radiotherapy, chemotherapy, or immunotherapy can be relied on to eradicate metastatic disease. Because of the paucity of systemic therapy for renal cell carcinoma, an aggressive surgical approach to the primary tumor is justifiable when all metastatic lesions can be excised or otherwise definitively treated and in experimental protocols in which adjuvant therapy of possible benefit can be combined with palliative nephrectomy. There is no evidence, however, in reported studies to suggest that routine palliative nephrectomy in patients who will not be offered adjuvant systemic therapy or radiation is beneficial. Such practice is also associated with a higher incidence of complications and mortality than is expected for resection of localized renal cell carcinoma. For these reasons, it is reasonable to recommend adjunctive nephrectomy only in certain selected instances, which include (1) the control of a patient's current symptoms related to the primary disease, for example, flank pain, hematuria, fever and toxicity, anemia, erythrocytosis, and hypercalcemia; (2) nephrectomy with the excision of a solitary metastasis; and (3) the patient who is willing to undergo experimental therapy, part of which involves removal of the primary tumor.
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PMID:The failure of infarction and/or nephrectomy in stage IV renal cell cancer to influence survival or metastatic regression. 331 66

A tumor thrombus in the vena cava (infrahepatic) was identified in a 70-year-old male with chronic obstructive lung disease, and right nephrectomy and thrombectomy were performed successfully. Therefore, he enjoyed good health for 6 months until he developed bone metastasis in the vertebrae and upper gastrointestinal bleeding. In another case of a 51-year-old male who presented with a mass in the posterior part of the chest; the biopsy specimen of the mass was reported to at least resemble renal-cell carcinoma. Subsequently, he underwent right nephrectomy and thoracotomy to remove the mass. He has since led an uneventful life without tumor recurrence. In our hospital from 1971 to 1980, 9 cases of renal-cell carcinoma have been experienced, including the above 2 cases. Their average age was 49.4 years, with ages ranging from 34 to 70 years. Seven patients presented with gross hematuria, and 2 patients, with flank pain. All 9 cases, all of whom underwent radical nephrectomy, were diagnosed pathologically as having renal cell carcinoma. The right side was involved in 3 cases, and the left, in 6 cases. The upper pole of the kidney was involved in 2 cases the middle in 1 case, and the lower in 5 cases. The mean 5-year survival rate was 69.2% and was closely associated with the tumor stage.
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PMID:[Report of two cases of advanced renal cell carcinoma and our experience at Mito Saiseikai General Hospital]. 344 71

A clinical study was made on 26 patients with renal cell carcinoma, who visited our department between October, 1979 and April, 1984. There were 21 men and 5 women. As the major initial symptoms, hematuria and flank pain were observed in 14 cases (53.8%), followed by symptoms of metastatic tumors in 7 cases (26.9%). Four cases of malignant renal masses which showed no abnormality on the excretory urogram were diagnosed by chance at the time of examination of the abdominal computed tomography (CT). CT was especially useful in diagnosing the renal cell carcinomas.
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PMID:[Renal cell carcinoma incidentally found by computed tomography: report of 4 cases]. 361 30

Leiomyosarcoma of the left kidney seen in a 58-year-old man is reported. On April 10, 1982, he complained of left flank pain. He visited our hospital and left solitary renal cyst was suspected. He had been treated as an outpatient, but left flank pain became exacervated. On May 18, he was admitted to our hospital. On June 7, radical nephrectomy was done under the diagnosis of left renal cell carcinoma. At operation, the tumor invased directory to the psoas muscle and abdominal wall, and could not be completely resected. Pathological diagnosis was renal cell carcinoma with sarcomatoid change. On July 1, he was discharged from the hospital. In December, left flank distention appeared and back pain became exacervated. On February 8, 1983, he was readmitted to our hospital. Low density area was found in left psoas muscle by CT scanning and recurrence of renal cell carcinoma was suspected. alpha-Interferon therapy had been done, but tumor increased remarkably and caused ileus. He died on June 14, 1983. The autopsy revealed a child head-sized cystic tumor in the upper retroperitoneal space, a 5 X 5 X 5 cm metastasis of the left lobe of the liver, a 3 X 3 X 4 cm tumor to the left upper lobe with cavity formation and direct invasion into the spleen, diaphragma and gastric serosa. These metastatic lesions were leiomyosarcoma. Retrospectively, the primary tumor of kidney revealed primary leiomyosarcoma of kidney.
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PMID:[A case of leiomyosarcoma of the kidney]. 372 30


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