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 medullary carcinoma (RMC), an aggressive malignant epithelial neoplasm, first emerged as a distinct clinicopathologic entity in 1995. It affects individuals 40 years of age or younger and is strongly associated with sickle cell disease or trait. The majority of patients with RMC have widely disseminated disease at the time of diagnosis and most fail to respond to both chemotherapy and radiotherapy. Mortality approaches 100%, and death usually occurs within a few months to a year of diagnosis. We report a 6-year-old African-American boy with a history of gross hematuria who died four weeks after diagnosis of disseminated metastatic disease. Autopsy showed a 4.4-cm renal mass with metastases to the contra lateral kidney, liver, lungs and multiregional lymph nodes. RMC should be included in the differential diagnosis of any patient 40 years old or younger with a history of hemoglobinopathy and gross hematuria and/or abdominal or flank pain. A brief discussion of the differential diagnosis, histogenesis and treatment is presented in this study.
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PMID:Renal medullary carcinoma in a six-year-old boy with sickle cell trait. 1453 Aug 15

Glomangiomas are a subset of glomus tumors that have a rich vascular network. Although a majority of the glomus tumors occur in the skin of the hand, they have also been reported in the deep soft tissue, bone, lungs, and gastrointestinal tract, especially the stomach. To our knowledge, only one such case has previously been reported primarily occurring in the liver. We report a case of a glomangioma primarily arising in the liver of a 57-year-old man who presented with right flank pain of several months' duration. A 3.0-cm hepatic mass was excised and consisted of numerous, small-to-medium branched vessels with the stroma containing small, round, regular cells with sharply outlined round-to-oval nuclei. Immunostains showed the tumor cells to be diffusely positive for vimentin and smooth muscle actin and to be focally positive for calponin. Collagen IV stained the pericellular matrix. The immunostain for CD34 highlighted the vascular network as well as outlined the tumor cells in many areas. Coexpression of actin and CD34 in glomus tumors, although unusual, has recently been reported in the literature. Despite its bland histology, the large tumor size and deep visceral location were suggestive of aggressive behavior; thus, a close clinical follow-up was recommended. The patient had an unremarkable postoperative course and has no evidence of metastatic disease 12 months after the procedure. An accurate diagnosis and an understanding the biology of this rare disease, especially in an unusual location, are crucial to its management.
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PMID:Primary glomangioma of the liver: a case report and review of the literature. 1498 33

Renal cell carcinoma was diagnosed in three male patients, 45, 53 and 52 years of age. In addition, they had paraneoplastic symptoms: hypercalcaemia, hyperglycaemia and elevated hepatic enzyme levels, respectively. All three patients underwent tumour nephrectomy, after which the paraneoplastic symptoms disappeared. The first patient died 16 months postoperatively, while the other two were alive and free of symptoms after a follow-up of nine months and four years, respectively. Many patients with renal cell carcinoma remain asymptomatic for a long period of time and 30% of all patients have metastatic disease at the time of diagnosis. The classic triad of flank pain, haematuria and an abdominal mass occurs in only 10% of all cases. However, 20-40% of all patients present with signs of a paraneoplastic syndrome, of which anaemia (20-40%), fever (30%), hypertension (24%), hypercalcaemia (10-15%) and hepatic dysfunction (3-6%) are the most common.
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PMID:[Paraneoplastic syndromes in three patients with renal cell carcinoma]. 1518 42

Metastatic prostate cancer has poor prognosis, with survival rates ranging from 1 to 3 years. Frequent sites for metastases are the skeletal system and lymph nodes; metastases to the gastrointestinal tract are rare. Although most patients become symptomatic with bone or flank pain, the patient we report initially presented with severe nausea and vomiting accompanied by moderate back pain. His prostate-specific antigen level was 171 ng/mL. Computed tomography and bone scan revealed retroperitoneal lymphadenopathy and bone metastasis. Cranial computed tomography was negative for metastasis but upper endoscopy and biopsy revealed a metastatic lesion from prostate cancer.
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PMID:Prostate cancer metastatic to the stomach. 1507 3

A 79-year-old man presented in August 2002 with right flank pain, anorexia, and gross hematuria. Physical examination was significant for a palpable, nontender, firm, and fixed mass in the epigastric region. Computed tomography scan of abdomen revealed a 15 cm tumor occupying almost the whole right kidney with extension into the inferior vena cava. The para-aortic and retroperitoneal lymph nodes were significantly enlarged. Examinations including bone scintigram and chest X-ray revealed no metastases. The patient underwent a ultrasound sonography-guided biopsy of the renal tumor, which showed a small cell carcinoma pathologically, and immunohistochemically. The patient received palliative treatment, and died in February 2003. We reviewed 25 cases including our case, and analyzed the clinical outcome of small cell carcinoma of the kidney.
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PMID:[Small cell carcinoma of the kidney: a case report]. 1510 Nov 68

Ameloblastoma is an uncommon disease in the urological field. The resulting tumors or cysts are of odontogenic epithelial origin, are usually benign in nature and rarely metastasize to distant organs. We describe a case of metastatic ameloblastic carcinoma in both kidneys of a 38-year-old Japanese man, who had a history of malignant ameloblastoma and was referred to us for evaluation because of gross hematuria and left flank pain. Computed tomography showed irregular cystic masses in both kidneys. After we confirmed that the primary lesion and the lung metastatic lesion had not recurred, we treated the patient surgically. Approximately 4 months postoperatively the patient suffered a local recurrence of tumors that was very invasive and aggressive. The patient died 2 months later and the autopsy showed local metastasis only, without any metastatic lesion in the lungs or other organs. The present case showed that malignant ameloblastoma is highly aggressive, and in the case of metastases the prognosis is usually extremely poor.
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PMID:Metastatic malignant ameloblastoma of the kidneys. 1515 15

We report the case of a 59-year-old woman who presented with right flank pain and fever. Diagnostic investigations revealed stenosis of the right ureter extending over about 1cm. Since a double-J prosthesis could not be passed through it, a percutaneous nephrostomy was constructed and surgical exploration and excision of the stenotic ureteral segment were then carried out. Histopathological analysis of the segment removed showed diffuse infiltration with epithelial tumor cells. On immunohistochemistry, these cells were found to be positive for cytokeratin and for estrogen and progesterone receptors. No primary cancer and no additional metastases were detected. Eleven months later a primary tumor with a metastasis in the left supraclavicular region was found in the patient's right breast.
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PMID:Ureteral metastasis of occult breast cancer. 1556 65

Renal cell carcinoma arising from epithelial cells of the renal tubule is a highly aggressive and malignant tumor in all ages. Less than 2% of cases occur in childhood, relatively in older age group. Only a few pediatric series have been presented in the English literature. Tumor is presented with characteristic findings of flank pain, gross hematuria, and palpable mass. Although one half of the patients have metastasis at the time of diagnosis, most cases are currently being incidentally detected using improved imaging techniques. The overall prognosis in children appears to be similar to that in adults. Tumor stage and complete surgical resection have been reported as the most meaningful prognostic factors for the outcome. The incidence of metastatic disease is same as in adults. The effect of chemotherapy and immunotherapy, either preoperatively or postoperatively, is unclear. Cure is the most likely consequence in localized and completely resected tumors. Here, we present an 8-year-old boy with renal cell carcinoma demonstrating only hematuria without any pathological physical examination findings. The mass was described by abdominal ultrasonography and computed tomography in the left kidney. After the left nephroureterectomy, the patient was given no therapy.
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PMID:Renal cell carcinoma: case report and literature review. 1593

Dermatomyositis is an uncommon in flammatory myopathy with characteristic cutaneous manifestations which is frequently linked to several cancers. A 42-year-old man presented with left flank pain with typical symptoms of dermatomyositis. Computed tomography showed a solid mass in the pelvis of the left kidney and lymphadenopathy in the retroperitoneum. Since the general condition of the patient rapidly deteriorated because of marked muscle weakness of the respiratory muscles, the patient initially underwent medical treatment with prednisolone. After the improvement of respiratory function, the patient underwent radical nephroureterectomy and retroperitoneal lymphadenectomy. The pathological specimen showed moderately differentiated adenocarcinoma, stage pT3N2. After surgery, the patient showed a marked improvement of clinical symptoms related to dermatomyositis. Twenty-two months later, multiple organ metastases occurred and the patient died of cancer. We should point out the significance of surgical and medical treatment for these patients.
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PMID:Advanced renal pelvic carcinoma associated with dermatomyositis. 1632 85

A 59-year-old man presented with a 2-month history of left flank pain and a possibility of gross hematuria. Left renal cell carcinoma stage II was diagnosed and radical left nephrectomy was performed. Twenty-two months postoperatively, lung metastases were demonstrated and 6 x 10(6) units of alpha-interferon (IFN-alpha) were administered for 9 months, only to keep the sizes of the metastases unchanged. Thirty-four months after the operation, liver metastases and bone metastasis in the left sacroiliac joint were revealed. The combination cytokine therapy was performed with 1.4 x 10(6) U of interleukin-2 (IL-2) and 3 x 10(6) U of IFN-alpha for 16 weeks, and the left sacroiliac joint metastasis was treated with radiation therapy of 4 Gy per day for 7 days. Six months after the 16 weeks of immunotherapy, computed tomography and bone scintigraphy revealed that the metastases of the lung, liver and bone substantially disappeared and this complete response is still kept after 16 months.
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PMID:Multifocal metastases of recurrent renal cell carcinoma successfully treated with a combination of low dose interleukin-2, alpha-interferon and radiotherapy. 1635 57


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