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)

Pleomorphic leiomyosarcoma (PLMS) of the adrenal gland is a rare tumor in an unusual location. A primary PLMS of the left adrenal gland is reported in a 59-yr-old Mexican woman who presented progressive flank pain and weight loss. The tumor measured 16 cm in diameter, showed markedly pleomorphic and osteoclast-like giant cells, necrosis, and high mitotic activity (average 15 per 10 high-power fields). The phenotype was supported by light microscopy and corroborated by immunohistochemistry. The neoplastic cells were strongly positive for muscle-specific actin, desmin, vimentin, and p53. They were negative for CD34, HMB45, estrogen receptors, and S-100 protein. The percentage of Ki-67 positive neoplastic cells was 7.6%. DNA content analysis by flow cytometry showed that tumor was diploid, with a high level of apoptosis. Extra-adrenal primary sites of origin were clinically excluded. The patient developed local recurrence and liver metastases 12 mo after initial treatment. She then received adjuvant chemotherapy and radiotherapy and the metastasis was resected. Twenty-four months later, she is alive with no evidence of disease. This is the second case of adrenal PLMS reported. This case exhibited a high histologic grade, aggressive behavior, and p53 overexpression, but diploid DNA content.
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PMID:Pleomorphic leiomyosarcoma of the adrenal gland with osteoclast-like giant cells. 1600 Aug 50

Leiomyosarcoma of the kidney is a rare entity with poor prognosis. Among renal sarcomas, it is the most common histologic subtype amounting to 50-60% of all cases. The tumors usually arise from either the renal capsule or smooth muscle tissue in the renal pelvic wall. We describe a case of renal leiomyosarcoma that presented with history of left flank pain. Physical examination was normal. Abdominal ultrasound showed a solid lesion of 38 x 36 mm arising from the left kidney. Intravenous urography showed cut off of both major and minor calyces of the left kidney from its pelvis with a normal right kidney. Exploratory laparotomy revealed a well-encapsulated mass confined to the renal parenchyma for which radical nephrectomy was performed. Histopathology showed a Grade I leiomyosarcoma arising from the renal capsule. Adjuvant chemotherapy and sandwich radiotherapy was given and he is disease free after six and half years of follow up. The rarity of this disease, its severity and poor prognosis, uncommon form of presentation, resulting delay in diagnosis and difficulty in management is highlighted and reported.
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PMID:Leiomyosarcoma of kidney: a case report with long term result after radiotherapy and chemotherapy. 1720 56

Sarcomas represent 1-2% of all malignant renal tumors in adults, with an incidence that increases with advancing age. Renal sarcoma is less common, but more lethal than sarcoma of any other genitourinary site. The common signs and symptoms associated with renal sarcoma in adults include palpable mass, abdominal or flank pain and hematuria similar to those seen with large, rapidly growing renal cell carcinomas. Usually, radical nephrectomy remains the treatment of choice for these tumors, which exhibits an aggressive biological behavior and an unfavorable prognosis. We describe an unusual case of renal leiomyosarcoma that underwent nephron sparing surgery, in a 55-year-old white woman, who had a renal mass for 3 years. The size of the renal mass did not change during this period and no distant metastasis occurred. The patient is still alive without any symptoms of relapse.
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PMID:Case report: good prognosis in leiomyosarcoma of the kidney. 1726 12

A 73-year-old Japanese woman was referred for examination of right flank pain and progressive hypertension. Abdominal CT incidentally detected a right adrenal mass 8 cm in size. The tumor exhibited isodensity by CT and contained high-intense lesion by T2-weighted MRI. Scintigraphy with (131) I-metaiodobenzylguanidine and (131) I-adosterol showed no abnormal uptake by whole body scan. Positron emission tomography scan with (18) F-2-fluoro-D-deoxyglucose demonstrated an exclusive uptake in the right adrenal mass. Adrenocortical hormone levels and catecholamine secretion were within normal range; however, the level of serum neuron-specific enolase (NSE) was found to be markedly high. After controlling systemic blood pressure with an alpha1-blocker, the right adrenal tumor was surgically removed, along with the right kidney and inferior vena cava which adhered to it. The tumor was pathologically proven to be leiomyosarcoma, which was immunohistochemically positive with alpha-smooth muscle actin and negative with CD57, S-100 and c-kit proteins. Notably, NSE protein was massively expressed in the resected tumor. After surgery blood pressure was controlled with regular medication and serum NSE levels have since normalized. The possibility of leiomyosarcoma should be kept in mind in adrenal incidentalomas with rapid growth and atypical radiological images. Our findings suggest that circulating NSE levels may be clinically useful for early detection of recurrence.
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PMID:A rare tumor in the adrenal region: neuron-specific enolase (NSE)-producing leiomyosarcoma in an elderly hypertensive patient. 1825 May 40

A 62-year-old woman presented with right flank pain, and computed tomography (CT) showed bilateral adrenal tumors (right, 8 cm; left, 4 cm). There were no abnormal findings on physical examination, and adrenal hormone levels in serum and urine were within normal limits. Radiological studies showed a right adrenal tumor with intratumoral hemorrhage, a cystic tumor in the left adrenal gland, and no sign of distant metastasis. Because laboratory tests showed normal levels of adrenal hormones, we considered the tumors to be nonfunctioning adrenal tumors. The right adrenal tumor was surgically removed because it was thought to be malignant, and histological examination revealed that it was a leiomyosarcoma. Postoperative CT showed a pleural metastasis in the right chest wall. The patient received combination chemotherapy with cyclophosphamide, vincristine, adriamycin, and dacarbazine. The metastasis was also treated with radiofrequency ablation (RFA). Because the left adrenal tumor grew rapidly despite two courses of the chemotherapy, it too was surgically removed. After the operation, metastasis in the right iliac bone was treated with RFA and radiotherapy. Positron emission tomography detected bilateral femoral metastases, and these were treated with radiotherapy in combination with a low dose of cisplatin. A liver metastasis and a small metastasis in the left kidney were treated with RFA and a metastasis in the pancreatic tail was removed surgically. Sixteen months after the right adrenalectomy, the patient died due to systemic spread of the disease. Multiple local treatments including RFA, radiotherapy, and resection were effective for the local control of metastatic lesions of adrenal leiomyosarcoma.
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PMID:Bilateral adrenal leiomyosarcoma treated with multiple local therapies. 1970 48

Sarcomas make up 1%-2% of all malignant renal tumors in adults, and the incidence increases with advancing age. Renal sarcomas are less common, but more lethal than sarcomas of any other genitourinary site. The common clinical presentation of renal sarcomas in adults include a palpable mass, abdominal or flank pain, and hematuria, similar to those seen with large, rapidly growing renal cell carcinomas. Usually, radical nephrectomy remains the treatment of choice for these tumors, which exhibit an aggressive biological behavior and an unfavorable prognosis. We describe an unusual case of bilateral renal leiomyosarcoma in a 61-year-old white male. The patient also had an uncle who had bilateral kidney cancer. In addition, our patient presented with a pulmonary embolism, which is different from the classic presentation of leiomyosarcoma. The patient did not undergo surgery, as the tumor had also invaded the surrounding vasculature and was felt to be unresectable by the consulting surgeons. He was treated with gemcitabine and docetaxel chemotherapy, with stabilization of disease.
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PMID:Bilateral leiomyosarcoma of the kidney with family history of kidney cancer. 1979 64

We report on a very large renal leiomyoma in a man presenting with a 1-year history of lower back and flank pain and a rapidly growing abdominal mass. Since a cystic renal cell carcinoma could not be ruled out, a postembolization right radical nephrectomy was performed. Diagnosis was confirmed by pathologic and histologic analysis. Renal leiomyomas are very rare benign tumours that are nearly indistinguishable from leiomyosarcoma or renal cell carcinoma preoperatively. This case represents the second largest such entity reported and demonstrates the limited ability of accurate diagnostic determination preoperatively, with pathologic examination and immune-histochemical staining postnephrectomy representing the only definitive means of diagnosis. A brief review of the literature and an outline of typical clinical and pathologic features of renal leiomyomas are also presented.
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PMID:Giant renal leiomyoma: a case report and brief review of the literature. 1982 21

We present a case of leiomyosarcoma of the right ovarian vein with MRI findings. The patient was a 52-year-old woman who had suffered from right flank pain for one week. Abdominal ultrasound and excretory urography revealed hydronephrosis of the right kidney. Ureteroscopy showed external compression at the right upper third of the ureter. CT and MRI of the abdomen revealed a retroperitoneal mass with compression of the right ureter. The retroperitoneal mass proved on histology to be a leiomyosarcoma arising from the right ovarian vein.
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PMID:Leiomyosarcoma of ovarian vein compression as a cause of hydronephrosis. 2179 30

Renal leiomyomas are rare benign tumours of the kidney originating from muscle cells. They are usually found by an autopsy, whether the patient is asymptomatic or has symptoms (i.e., abdominal/flank pain, hematuria, palpable mass). Today the widespread use of ultrasonography and computed tomography has increased the detection of clinically asymptomatic renal leiomyomas. The differential diagnosis between leiomyomas and other malignant lesions (above all renal cell carcinoma or leiomyosarcoma) is still possible by histological examination. Radiological examinations are not sufficient for the differential diagnosis. Renal leiomyomas have no aggressive behaviour and they usually do not metastasize. The prognosis, after surgery, is excellent without recurrence. We report a case of leiomyoma in a 31-year-old man who presented hematuria and flank pain. We also review the literature and provide a summary of clinical, radiological and histological features of renal leiomyomas.
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PMID:Renal leiomyoma: Case report and literature review. 2251 43

A 79-year-old man presented with a mass lesion under the left kidney that was revealed by abdominal ultrasonography. The retroperitoneal tumor was removed by transabdominal exploration. Histopathological diagnosis was a leiomyosarcoma. Seven years after the first operation, he presented with left flank pain. Computed tomography showed a mass lesion in the abdominal wall. Tumor resection was performed. The pathological diagnosis was recurrence of leiomyosarcoma. The patient remains free from disease recurrence 1 year after the second surgery.
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PMID:[A case of retroperitoneal leiomyosarcoma with abdominal wall recurrence 7 years after the first operation]. 2307 Mar 87


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