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

Angiomyolipoma is an uncommon benign tumor of the kidney. The tumor is composed of fat, smooth muscle, and blood vessels. The same pathological entity can appear in two clinically different forms, with or without tuberous sclerosis. We present two cases of renal angiomyolipomas with unusual manifestations. One was associated with tuberous sclerosis and both had the presentation of acute abdomen. Case one presented with epilepsy, angiofibroma, subungual fibroma, periventricular calcification, and bilateral renal angiomyolipomas. Tuberous sclerosis is characterized by these findings. Both cases had spontaneous hemorrhage with hypovolemic shock. Massive hemorrhage resulting in shock is uncommon and the incidence has been estimated to be about 10 per cent. In fact, many angiomyolipomas are clinically occult. The size of the tumor correlates well with the presence or absence of symptoms which include microhematuria, flank pain, hypertension and urinary tract infection. Abdominal CT is the preferred modality for diagnosis of angiomyolipoma. The most important finding is the presence of an intrarenal tumor with fat component which is recognized as a relative low density on CT. Our patients were hospitalized under the impression of angiomyolipoma after the CT study. In addition, the CT defined either the size of the tumor or the extension of the hemorrhage. Although many believe that renal angiography is not sufficient by itself to establish the diagnosis of angiomyolipoma, occasionally it is mandatory in the management of the tumor. The management is decided by two factors, the size of tumor and the clinical presentation. The attitude of management should include conservative treatment with regular follow-up, selective arterial embolization, enucleation, and partial or total nephrectomy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Unusual presentations of angiomyolipoma]. 179 71

A series of 24 patients with renal angiomyolipoma was reviewed. Their ages ranged from 10 to 70 years (average 41). Four cases were associated with tuberous sclerosis, 1 with spinal neurilemmoma, 1 with transitional cell carcinoma and another with renal tuberculosis. The presenting symptoms in decreasing frequencies were flank pain, mass, haematuria, fever, syncope and respiratory distress. Although it has often been said that angiomyolipomas associated with tuberous sclerosis are small and asymptomatic, all 4 such patients in this study had large symptomatic tumours. Before the advent of CT scan and ultrasonography, the pre-operative diagnostic rate for cases unassociated with tuberous sclerosis was 10% (1/10). With the combined use of these 2 modalities, the diagnostic rate increased to 60% (6/10). Most patients in this series were treated with nephrectomy. However, equally good outcomes occurred in 2 patients who received partial nephrectomies. Pre-operative diagnosis now makes it possible to consider more conservative management.
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PMID:Renal angiomyolipoma: report of 24 cases. 226 29

A case of bilateral renal angiomyolipoma without tuberous sclerosis is reported. A 49-year-old woman was admitted to the general practitioner with a sudden onset of severe left flank pain. An excretory urogram and ultrasonogram revealed an enlargement of the left kidney. She was subsequently referred to our clinic for further investigation and treatment. Computed tomographic scan and magnetic resonance imaging using Tl-weighted image showed several tumors with a fatty, dense area in the bilateral kidney. An arteriogram demonstrated a hypervascular renal mass with aneurysms in her left kidney. Diagnosis of bilateral renal angiomyolipoma was confirmed by percutaneous needle biopsy. Superselective embolization of the tumor was successfully performed, preserving normal renal tissue. Gelatin sponges containing Carboquone (CQ sponge) were used as embolic material. Angiomyolipoma has become relatively easy to diagnose by CT, ultrasound, MRI and so on. However, there are some cases of angiomyolipoma which are indistinguishable from renal cell carcinoma using these modes of testing. Therefore, in selecting a conservative management, we indicated that percutaneous biopsy or open biopsy should be done to confirm the results of the above procedures. Moreover, therapeutic embolization for angiomyolipoma was concluded to be very useful.
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PMID:[Therapeutic embolization of renal angiomyolipoma: a case report]. 280 11

A 47-year-old woman experienced sudden onset of severe left flank pain. By computed tomography (CT) and arteriography, her condition was diagnosed as a ruptured angiomyolipoma of the left kidney. She did not have tuberous sclerosis. Using polyvinyl alcohol foam (Ivalon) particles, immediate embolization of a main artery feeding the tumor--the posterior branch of the left renal artery--was performed. Three months after embolization, intravenous digital subtraction angiography (IVDSA) showed this main feeder was still occluded. This case and others encountered in our review of the literature underscore the usefulness of therapeutic embolization for renal angiomyolipoma.
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PMID:Therapeutic embolization for renal angiomyolipoma: case report and review of the literature. 333 Aug 27

A case of bilateral renal angiomyolipoma is reported. A 21-year-old female visited our hospital with the complaint of severe left flank pain and macroscopic hematuria Bilateral renal mass was suspected from the intravenous pyelography. CT scan revealed bilateral renal angiomyolipoma accompanied by retroperitoneal bleeding. There were no symptoms or signs of tuberous sclerosis. Left partial nephrectomy and right tumor enucleation were performed uneventfully with no recurrence during 4.5 years of follow-up. Several case reports of renal angiomyolipoma have been documented; we sum up these cases with special consideration as to treatment. In the majority of the cases, nephrectomy has been performed after retroperitoneal bleeding. We emphasize that in some cases it is favorable to carry out renal-tissue-conserving operation before the occurrence of the bleeding, because the angiomyolipoma tends to rupture easily.
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PMID:[Bilateral renal angiomyolipoma: report of a case]. 337 95

A case of renal angiomyolipoma originating from polycystic kidney with horseshoe kidney is reported. A 32-year-old woman visited our hospital with the complaint of proteinuria. with computerized tomographic scan and further examinations the patient was diagnosed as having renal angiomyolipoma with tuberous sclerosis. The tumor originated from a polycystic horseshoe kidney. Three weeks later, she complained of right flank pain and was diagnosed with spontaneous rupture of the angiomyolipoma. Right heminephrectomy was performed and histological examination confirmed the preoperative diagnosis. Some discussion is made on the characteristics and treatment of renal angiomyolipoma, and the statistics on renal diseases with tuberous sclerosis in Japan are presented.
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PMID:[A case of angiomyolipoma originating from polycystic kidney with horseshoe kidney]. 343 97

A series of nine patients surgically treated for histologically verified renal angiomyolipoma is presented. Only one patient had extrarenal stigmata of tuberous sclerosis. No evidence of malignancy was found. In three cases a preoperative diagnosis was achieved with computed tomography (CT), use of which is recommended in evaluation of renal tumours. Six angiomyolipomas were solitary and three bilateral. Abdominal or flank pain was present in eight cases and perirenal haemorrhage in four. Solitary tumours were treated with nephrectomy. For bilateral tumour, nephrectomy and conservative renal surgery were used in two cases and bilateral nephrectomy and kidney transplantation were performed in the third case. When adipose tissue containing renal tumour is demonstrated at CT, conservative surgery should be considered.
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PMID:Diagnosis and treatment of renal angiomyolipoma. 354 5

Two cases of renal angiomyolipoma without tuberous sclerosis are reported. The first case was of a 35-year-old man with complaints of right upper abdominal and right flank pain. Preoperative diagnosis was right renal angiomyolipoma. Thoracoabdominal radical nephrectomy and lymphadenectomy were performed. The pathological diagnosis was renal angiomyolipoma with lymph node involvement. The second case was of a 46-year-old woman whose left renal mass had been accidentally found by ultrasound study. Preoperative diagnosis was left renal angiomyolipoma. This tumor was enucleated from the left kidney through flank incision.
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PMID:[Two cases of renal angiomyolipoma]. 361 28

Two cases of renal angiomyolipoma with tuberous sclerosis are reported. The first was a 42-year-old housewife with complaints of left flank pain, palpable mass at the same region and in a preshock state. Ultrasonogram of the left kidney demonstrated a large echogenic mass with fluid. Preoperative diagnosis was renal angiomyolipoma with spontaneous rupture. Emergency nephrectomy and lymphadenectomy were performed. The histopathological diagnosis was renal angiomyolipoma with nodal involvements which reflects the multicentricity of the disorder. The second was a 44-year-old housewife with dull right flank pain. CT scan showed a mass in the upper part of the kidney which had an attenuation value of -60 HU. Adrenal tumor could not be distinguished from renal tumor by selective renal angiogram. Nephrectomy was performed and histopathological diagnosis was renal angiomyolipoma. Both cases remain well. We reviewed 32 cases of renal angiomyolipoma with spontaneous rupture in the Japanese literature with respect to age, affected side, presence or absence of tuberous sclerosis, preoperative diagnosis and treatment. Previous diagnoses were done with plain film, excretory urogram and angiogram. Preoperative diagnosis of angiomyolipoma was difficult or impossible, and operative procedure of choice was nephrectomy. Now CT and ultrasonogram are the specific tools in the diagnosis of angiomyolipoma. Partial nephrectomy, enucleation or observation is selected because renal angiomyolipoma is a benign tumor.
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PMID:[Renal angiomyolipoma: report of two cases (including a case with spontaneous rupture)]. 639 88

Two cases of renal angiomyolipomas in female siblings associated with tuberous sclerosis were reported. The first case was a 47-year-old housewife who visited the hospital because of severe right flank pain. Bilateral renal angiomyolipomas and hemorrhage in the right angiomyolipoma were recognized by computerized tomography, ultrasonography and renal angiography. After 2 months she had another episode of left flank pain and was diagnosed to have hemorrhage in the left renal tumor. The pain remissed by conservative treatment. Bilateral nephrectomy and hemodialysis would be necessary if she were to have a third attack. The second case was her 36-year-old sister with the chief complaint of left flank pain and genital bleeding. CT and renal angiography suggested a large angiomyolipoma in her left kidney and a small one in her right kidney. Left nephrectomy, right partial nephrectomy and hysterectomy were performed to prevent intratumoral hemorrhage. The histopathological diagnosis was angiomyolipoma of kidneys, uterus and lymphnodes of right renal hilus. Although pre-operative differentiation of angiomyolipoma from renal cell carcinoma has been difficult, recently diagnosis has become possible by CT, ultra-sonography and angiography.
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PMID:[Renal angiomyolipoma: report of 2 cases of tuberous sclerosis in female siblings]. 651 96


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