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

Renal leiomyomas large enough to be clinically diagnosed are extremely rare. We review 30 cases of clinically diagnosed renal leiomyoma from the literature in Japan, including our 2 new cases. Case 1: In a 52-year-old man with no symptoms a renal mass was found accidentally on an ultrasonogram. CT scan showed a mass with a cystic area at the upper pole of the right kidney. Angiogram showed a hypovascular mass. Case 2: CT scan revealed a cystic mass and angiogram showed an avascular mass at the upper pole of the left kidney in a 19-year-old man having gross hematuria and left flank pain. Transperitoneal nephrectomy was done in both cases. Histologically each tumor was composed of monotonous proliferation of spindle shaped cells without atypia, which showed intense immunoreactivity for alpha-smooth muscle actin. The diagnosis of benign leiomyoma was made in each case. In a review of 30 cases, we found that renal leiomyomas occur most often in female (77%), between decades 2 and 5 of life (median: 46 years). On the angiogram it appears most often as an avascular or hypovascular mass. CT scan shows cystic or mixed solid/cystic or solid lesion, occasionally with calcification. Preoperative diagnosis is extremely difficult to be made. Histologically, fibroma, angiomyolipoma, congenital mesoblastic nephroma and leiomyosarcoma should be differentiated.
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PMID:[Two cases of leiomyoma of the kidney]. 156 55

A primary leiomyosarcoma of the right adrenal gland is reported in a 49-year-old male who presented with progressive flank pain. This is the second case in the English language literature and the first to have documentation of malignant behavior. The tumor measured 11 cm in diameter and showed marked necrosis with prominent mitotic activity (average 15 per 10 high-power fields). Smooth muscle differentiation was apparent ultrastructurally and confirmed by positive immunostaining for muscle-specific and alpha-smooth muscle actin. Bony metastases developed; following palliative treatment with radiation and chemotherapy, the patient is alive with tumor 9 months later. Origin from smooth muscle associated with the central adrenal vein or its tributaries is proposed.
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PMID:Primary leiomyosarcoma of adrenal gland. Case report with immunohistochemical and ultrastructural study. 195 46

In October 14, 1982, a 30-year-old male was admitted to the hospital because of a left flank pain and melena. On undergoing testing, an upper gastrointestinal series revealed barium retention in the small bowel, in which an abdomen X-p showed an abnormal gas shadow. Endoscopic examinations revealed depressive lesions, and the histological diagnosis was malignant neoplasm with a duodenal wall infiltration. A superior mesentric arteriogram showed the dilatation of the media colic artery and neovascular lesions. Thus a leiomyosarcoma of the small intestine was suspected, and the patient underwent surgery on November 15. The tumor was sack-like and looked black; histologically it was diagnosed as a small intestine, because the primary origin was only detected in the small intestine. Four months after the operation, the tumor recurred and the patient died in June, 1983.
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PMID:[A primary malignant melanoma of the small intestine]. 236 30

A case of renal leiomyosarcoma ruptured spontaneously is reported. A 36-year-old man was admitted to our clinic with the complaint of right flank pain. The urographic examination, including an excretory urography, renal CT-scan, renal angiography, and ultrasonography revealed a renal tumor with spontaneous rupture on the right side. A nephrectomy through the lumbal flank incision on the right side was performed on February 28, 1984, and histopathological diagnosis was renal leiomyosarcoma. Five courses of adjuvant chemotherapy, VCR, ADM and CPM, combined with maintenance immunochemotherapy using Tegafur and Krestin and with radiotherapy (3,000 rad) were performed post-operatively. The patient was followed for 18 months after operation as an outpatient with no evidence of local recurrence and metastasis. The 40 reported cases including our case with leiomyosarcoma in Japan is reviewed and some characteristics of this entry are discussed.
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PMID:[Spontaneous rupture of renal leiomyosarcoma: report of a case]. 310 46

A case of renal leiomyosarcoma seen in a 65-year-old man is reported. On November 15, 1985, he complained of right flank pain and high fever. On right renal angiography and computed tomography showed a mass on lower pole of the right kidney. On December 10, 1985, the patient underwent right radical nephrectomy. The histological diagnosis was leiomyosarcoma probably originating from the right renal capsule. Forty-six cases of renal leiomyosarcoma, including this case, in the Japanese literature have been reviewed and are discussed.
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PMID:[A case of leiomyosarcoma of the kidney]. 342 21

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

A 57-year-old man was admitted with complaints of progressive anorexia, weight loss and right flank pain. He had been treated for basal-cell carcinoma of the skin 19 years before. On physical examination, eight moles in the face, back and left thigh were found along with palmar pits. In addition, a painful induration in his right thigh was evident. Biopsy proved that six moles were basal-cell carcinomas and the thigh mass a high-grade leiomyosarcoma. Computed tomographs revealed multiple metastases in the lungs and the liver. The patient was treated with epirubicin, with partial response, and subsequently with ifosfamide. He died 17 months after diagnosis. Whereas the world literature records several cases of soft tissue tumors in patients with nevoid basal-cell carcinoma syndrome, this is the first report of a simultaneous occurrence of leiomyosarcoma and nevoid basal-cell carcinoma syndrome.
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PMID:Leiomyosarcoma of the soft tissues in a patient with nevoid basal-cell carcinoma syndrome. 783 73

A 68-year-old man visited his home doctor with the chief complaint of left flank pain. Abdominal ultrasonography revealed left hydronephrosis and space occupying lesion in the right kidney. He was referred to our hospital because of suspected left ureteral stone and for further examination. Drip infusion pyelography revealed a left ureteral stone and retrograde pyelography showed extrinsic compression and deformation of the right pyelogram. A computed tomography showed a heterogeneous solid mass, 7 x 4 cm in size, compressing the pelvicocalyceal system and growing out of the kidney. Right radical nephrectomy was performed under the diagnosis of renal cell carcinoma. The pathological diagnosis was leiomyosarcoma. Seventy-five cases of renal leiomyosarcoma have been reported in the Japanese literature and this is the third case as an incidental tumor. Because of the absence of the characteristic diagnostic signs, this malignant tumor can present diagnostic difficulty. The diagnostic problems and clinical features of renal leiomyosarcoma are discussed.
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PMID:[A case of incidental renal leiomyosarcoma]. 802 63

A 53-year-old female visited our out-patient department complaining of right flank pain. Ultrasonography revealed a solid mass lesion in the lower pole of the right kidney and further evaluation was scheduled. A few days later, she suddenly felt pain at the abdominal enlarged mass. Computed tomographic (CT) scan revealed a huge retroperitoneal mass with heterogenous density. Spontaneous rupture of renal tumor was suspected and emergency nephrectomy was performed. The ruptured tumor was pale, elastic firm and invaded directly to the duodenum. Histopathological findings revealed fibrous cells with frequent nuclear mitosis. Smooth muscle actin was identified immunohistochemically. Therefore, the tumor was diagnosed as leiomyosarcoma. The patient died 2 months after operation due to perforation of the intestine.
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PMID:[A case of spontaneous rupture of renal leiomyosarcoma]. 888 67

Leiomyosarcomas of vascular origin is a rare and aggressive pathology, its presentation on the renal vein is infrequent, of which 29 cases have been reported world-wide. We describe a case of a 76 year-old woman, who presented with intermittent left flank pain, irradiated to the lumbar region of 6 months duration. A left radical nephrectomy with en-bloc resection of a para-aortic tumor was performed. Microscopic examination of the specimen reported a moderately differentiated leiomyosarcoma, originated in the wall of the renal vein. The patient received adjuvant chemotherapy and radiation therapy. The tumor recurred in the liver. After 24 months from the primary surgery, the patient is alive with evidence of multiple metastatic spread to the liver. She is now under palliative care.
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PMID:Leiomyosarcoma of the renal vein: case report and review of the literature. 1588 79


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