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)

Renal AML are rare benign tumors of the kidneys consisting of fat tissue intermixed with thick-walled blood vessels and smooth muscle. Due to the easy access to modern imaging techniques more and more AML are detected incidentally during diagnostic evaluation of common urological disease before getting symptomatic (mostly flank pain, hematuria). The presence of a highly echodense renal mass on ultrasound and the detection of even small amounts of fat in CT usually allows to establish the diagnosis of AML. If these procedures give still equivocal results, angiography and MRI may become necessary. When report a case of a patient with AML where all the imaging techniques including magnetic resonance were nonconclusive. The correct diagnosis could only be established by histological examination after surgical resection. Indeed, the presence of a large hematoma had masked all the characteristic features of AML in this case.
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PMID:The role of imaging techniques in diagnostic evaluation of angiomyolipomas. 175 64

AML is a benign renal tumor composed of variable quantities of mature vascular, smooth muscle and fatty elements. They occur as an isolated finding, classically in middle-aged females, or in association with tuberous sclerosis. When symptomatic, they typically present with flank pain secondary to hemorrhage. CT is the diagnostic imaging modality of choice. The diagnosis can usually be made based on the recognition of fat within the lesion. When discovered, asymptomatic lesions are generally monitored by follow-up imaging studies, and if they remain stable, no intervention is required. Arterial embolization has become the recommended treatment of choice in some instances, particularly in cases with associated hemorrhage.
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PMID:Worsening right flank pain over a 24-hr period. 941 86

Myeloid sarcoma (MS) is an extramedullary solid tumor composed of leukemic myeloid cells. MS is an uncommon tumor complicating acute myeloid leukemia (AML), or less often myelodysplestic syndrome (MDS) and myeloproliferative disorders. Rarely, MS may precede the systemic onset of AML, which usually follows within months. We report a 36 year-old lady who presented with a cervical-uterine mass, which proved to be MS. Initially, she had no systemic AMLand was treated with hysterectomy and systemic chemotherapy. She developed bilateral-flank pain and renal impairment after 9 months. Imaging revealed a soft-tissue mass in the para-aortic and peri-sacral region with bilateral hydronephrosis. Biopsy from the mass confirmed recurrence of MS. Bone marrow (BM) biopsy revealed 20% blasts consistent with AML. She was treated with aggressive chemotherapy and local radiotherapy. Despite these measures, she died of progressive disease. MS should be considered and treated as systemic AML, rather than an isolated mass; and we discuss management issues in such patients.
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PMID:Isolated Uterine Myeloid Sarcoma Preceding the Diagnosis of Acute Myeloid Leukemia. 2737 23

A 46-year-old male presented with left flank pain and was found to have left nephromegaly with renal vein and inferior vena cava (IVC) thrombus. On hematological evaluation, he had leukocytosis and thrombocytopenia. Further evaluation revealed acute myeloid leukemia (AML). Following initial cytoreductive therapy and supportive care for hyperleukocytosis, he underwent left simple nephrectomy with IVC thrombectomy. Postoperatively, he developed massive thrombosis of infrahepatic IVC with renal failure. Renal venous thrombosis as a rare presentation of AML in adults with leukemic hyperleukocytosis has not been reported. In the absence of clear guidelines, early diagnosis and management are desirable.
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PMID:Renal Vein Thrombosis as Presentation of Non-M3 Acute Myeloid Leukemia in an Adult Patient. 2986 66

Transplant-associated thrombotic microangiopathy (TA-TMA) is a rare complication of hematopoietic stem cell transplantation (HSCT) with variable presentations. TA-TMA has often been described as a diagnosis of exclusion but a renal biopsy is rarely pursued to confirm the diagnosis, an essential step for our patient with renally limited TMA. We report a case report from the onconephrology clinic and review the literature associated with TA-TMA as it relates to diagnosis and treatment. A 45-year-old woman with acute myeloid leukemia and stage 3 chronic kidney disease underwent a matched unrelated donor allogenic HSCT. Postoperatively, she developed gastrointestinal graft versus host disease (GvHD) and was treated with tacrolimus, sirolimus, budesonide, and beclomethasone. Following discharge, she developed uncontrolled hypertension and required losartan, amlodipine, carvedilol, clonidine patch, and hydralazine as needed. On day 180 post-transplant, she developed lower extremity edema and acute kidney injury (AKI) with creatinine increasing to 2 mg/dL. On day 480 post-transplant, she developed worsening thrombocytopenia, anemia, new hematuria, left flank pain, and worsening renal function with creatinine peaking to 6 mg/dL. Peripheral smear revealed no schistocytes, lactate dehydrogenase of 265 mg/dL, and urinalysis with 100 mg/dL protein. ADAMTS 13 activity was normal (92%) and no inhibitor was detected. She became anuric and was started on hemodialysis. Renal biopsy revealed glomerular changes consistent with TA-TMA. During HSCT, systemic vascular endothelial injury triggers microangiopathic hemolytic anemia, platelet consumption, injury of glomerular endothelial cells and fibrin occluded renal capillaries. Thus, TA-TMA should be considered in HSCT patients with elevated LDH, proteinuria, hypertension, and AKI. However, a diagnosis is difficult to confirm without a renal biopsy. Treatment involves discontinuing potentially toxic agents such as calcineurin inhibitors and sirolimus, prescribing adequate antimicrobial treatment, and using renal replacement therapy if needed. A renal biopsy early in the course of disease not only confirms the diagnosis, but may limit the extent of disease.
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PMID:Thrombotic Microangiopathy With Granulomatosis Interstitial Nephritis in an Allogenic Bone Marrow Transplant Patient: A Case Report and Review of the Literature. 3230 Mar 93

Renal angiomyolipoma (RAML), a rare benign mesenchymal tumor, consists of variable proportions of thick-walled blood vessels admixed with adipose tissue and bundles of smooth muscle. Rarely, RAML angiomyolipoma may be associated with pseudoaneurysm, spontaneous rupture and hemorrhage. we herein present an exceptional case of fat-poor RAML containing a large pseudoaneurysm in a 48-yearold woman with known pulmonary lymphangioleiomyomatosis (PLAM), who was admitted to hospital due to right flank pain for about two months. To avoid risk of rupture of the pseudoaneurysms, transcatheter arterial embolization (TAE) procedure was performed, at the same time taking into account of the possibility of malignancy in such a large neoplasm, right radical nephrectomy was taken five days later. This case was benign and the 1-year follow-up ultrasonic examination showed no recurrence. This is the first report that the patient had a sporadic giant RAML with pseudoaneurysm which was not associated with the TSC, and to our knowledge, such cases have not been explored in literature. This case reminds us that giant sporadic RAML with pseudoaneurysm, although rare, does exist, and we should improve the understanding of the neoplasm. Early detection and therapeutic interventions of pseudoaneurysm in an AML patient can reduce serious complications.
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PMID:Fat-poor renal angiomyolipoma combined with pseudoaneurysm: a case report. 3252 22

Tuberous sclerosis complex has several renal manifestations like angiomyolipomas. We report a case of a giant AML and discuss its diagnosis and treatment. A 42-year-old woman was admitted to emergency department due to flank pain and hematuria. The patient had history of mental retardation and epilepsy. Abdominal CT without contrast medium revealed a large mass with a fat/blood content inside. On those findings, we diagnosed the patient a bleeding giant AML. We performed selective embolization of the bleeding source with subsequent conservative management. TSC-associated AMLs occur more frequently as multiple lesions and grow to larger size than idiopathic AML.
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PMID:Conservative treatment of monolateral giant renal angiomyolipoma in a patient with Tuberous Sclerosis Complex (TSC): A case report. 3310 10