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)

We report 3 cases of synovial sarcoma with rhabdoid features, initially diagnosed as adult rhabdoid tumors. Two women (case nos. 1 and 2, 35 years and 27 years of age, respectively) and one man (case no. 3, 26 years of age) presented to their physicians with right flank pain. On physical examination, a poorly defined, firm, palpable mass was found in the upper right quadrant of the abdomen in all cases. Sonography and computed tomography revealed solid, cystic masses in the right kidneys that ranged in size from 8.5 to 20.0 cm. Right radical nephrectomies were performed in all patients. One patient died of disease, and the other two patients were alive and disease-free after chemotherapy and radiotherapy. Microscopic examination revealed that the tumors were composed mostly of rhabdoid cells with eccentrically located nuclei, prominent nucleoli, and eosinophilic cytoplasm. We also found areas of fasciculated spindle cells, sharply separated from or irregularly admixed with areas of rhabdoid cells. There was tumor necrosis, but no epithelial areas were seen. Hemangiopericytic vasculature was at least focally observed in all cases. The tumor cells were positive for CD99 and bcl-2 in all cases and for CD56 in two cases and negative for CD34 and smooth muscle actin in all cases. The cells in case no. 1 were focally positive for cytokeratin. To verify the possibility of synovial sarcoma with rhabdoid features, reverse transcriptase polymerase chain reaction using RNA extracted from frozen tissue in case no. 1 and formalin-fixed, paraffin-embedded tissue in case nos. 2 and 3 was performed. SYT-SSX2 transcripts were detected in all 3 cases. These cases indicate that synovial sarcoma of the kidney should be considered in the differential diagnosis of mesenchymal kidney tumors with prominent rhabdoid features. A subset of adult rhabdoid tumors may be a rhabdoid variant of synovial sarcoma, and molecular studies to detect SYT-SSX fusion transcripts are recommended for an accurate diagnosis.
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PMID:Synovial sarcoma of the kidney with rhabdoid features: report of three cases. 1510 52

Primary renal synovial sarcoma (SS) was first described in 2000 by Argani, with only a few subsequent cases being reported in the English literature. Herein, we describe a case of a 52-year-old woman who presented with right flank pain. Magnetic resonance imaging revealed a 6-cm mass in the lower pole of the right kidney. T1 and T2 weighted imaging revealed a heterogeneous mass with triple sign. There was post-contrast enhancement. Imaging, histology and immunostaining together made the diagnosis of SS of the kidney.
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PMID:Magnetic resonance imaging features of renal synovial sarcoma: a case report. 1839 Mar 87

Primary renal synovial sarcomas (SS) are rare tumors of the kidney. Faria et al first described primary renal synovial sarcoma in 1999 (Mod Pathol 12:94A). In this paper we present a primary renal synovial sarcoma case and review the 41 primary renal synovial sarcoma cases reported to date. Primary renal synovial sarcomas can exist in either a monophasic or a biphasic pattern. The monophasic variant of primary renal synovial sarcoma is more common and tends to have a better prognosis than the biphasic variant. We present in this paper, a 68-year-old woman with primary renal synovial sarcoma. She presented with right flank pain and abdominal distention. Postoperative pathology of the 20 cm mass on magnetic resonance imaging showed histologic and immunochemical features of synovial sarcoma with coexisting spindle and epithelial cells. She underwent adjuvant ifosfamide and doxorubicin chemotherapy and was free of disease at 1 year after diagnosis. As a conclusion, physicians should be aware of the possibility of malignancy in cystic renal masses and that synovial sarcoma is one of the possibilities.
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PMID:A case of renal synovial sarcoma treated with adjuvant ifosfamide and doxorubicin. 2180 84

Mixed epithelial and stromal tumor of the kidney is a recently described neoplasm that predominantly affects perimenopausal women. Although typically benign, few cases with malignant features have been reported. Here, we report the second male case of malignant mixed epithelial and stromal tumor of the kidney with sarcomatous transformation. The patient presented with abdominal discomfort and right flank pain. Computed tomography (CT) of the abdomen revealed a large mass arisen from the right kidney with solid and focal cystic components. The patient underwent right radical nephrectomy. Histologic sections showed benign and malignant components. The benign component consisted of multiple tubules and variably sized cysts lined by benign epithelium. The malignant component was predominantly composed of undifferentiated cellular spindle cell sarcoma. By immunohistochemical studies, the epithelial component was positive for cytokeratins and epithelial membrane antigen (EMA). The stromal component displayed strong immunohistochemical expression of vimentin, CD-99, bcl-2; and was negative for cytokeratins, desmin, SMA, S-100, estrogen receptor (ER) and progesterone receptor (PR). Analysis by reverse transcriptase polymerase chain reaction (RT-PCR) failed to identify the SYT-SSX1 or SYT-SSX2 fusion transcripts characteristic of synovial sarcoma. Subsequently adjuvant chemotherapy was given. The patient developed a local recurrent tumor 9 months after operation.
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PMID:Malignant mixed epithelial and stromal tumor of the kidney: the second male case and review of literature. 2496 82

Synovial sarcoma (SS) is a soft-tissue tumor with a unique t(X;18)(p11.2;q11.2) chromosomal translocation that can be identified by polymerase chain reaction in tissue homogenates. Generally, the tumor occurs in the proximity of the joints. The current study presents the case of a 54-year-old female with primary SS (PSS) of the right kidney; this is an extremely rare tumor accounting for <2% of malignant renal carcinomas. The patient presented with an interrupted right flank pain of 20 years duration, with a precipitating factor of a hematuria of 8 days. Abdominal computerized tomography (CT) scan revealed a heterogeneous, unclear-marginated soft tissue arising in the upper pole of the right kidney with solid, necrotic components and heterogeneous enhancement. Renal cell carcinoma was diagnosed pre-operatively. A right nephrectomy was performed, and the patient is currently free of metastasis 12 months after the surgery. The current treatment for renal SS includes surgical resection and ifosfamide-based chemotherapy. To the best of our knowledge, <50 cases have been reported in the English literature. Urologists should be aware of the possibility of malignancy in cystic renal masses and consider a diagnosis of SS. Along with the case report, the current study presents a literature review on the diagnosis and treatment of PSS.
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PMID:Primary synovial sarcoma of the kidney: A case report. 2678 66