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)

A 32-year-old housewife with gross hematuria and right flank pain had excretory urography and angiography performed. A large right renal mass with neovascularity was demonstrated. Computerized tomography also revealed a large well-demarcated renal mass with low value of HU. Right nephrectomy was done and histopathological diagnosis was angiomyolipoma weighing 1100 g. A statistical study was made on 147 cases of renal angiomyolipoma in the Japanese literature including this case. The male to female ratio was 1 to 2.9, and the average age of male and female patients was 37.8 and 39.0 years, respectively. Thirty-eight per cent of the cases were associated with tuberous sclerosis. The main clinical signs were flank pain, flank mass and hematuria. In 80% of the cases, nephrectomy was done because of the difficulty of preoperative differential diagnosis from renal cell carcinoma. Recently, CT and sonography have become a great help in diagnosing angiomyolipoma, because they can demonstrate the fat in the renal mass. Conservative or surgical treatment to save the kidney can be used more often when it becomes possible to make a clear differential diagnosis between angiomyolipoma and other malignant diseases.
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PMID:[Angiomyolipoma: a case report and a statistical study of 147 cases in Japanese literature]. 667 26

Two cases of renal angiomyolipoma without tuberous sclerosis are presented. The 1st case was a 33-year-old woman who had left flank pain and macroscopic hematuria on August 26, 1980. Physical examinations revealed a large left renal tumor, and selective renal angiograms showed the presence of a hypovascular mass located in the central to median lower part of the left kidney. Ultrasonography showed a high echogenic mass accompanied by a round low echogenic area in the left kidney. Computed tomography revealed a fatty density in the renal mass. The 2nd case was a 60-year-old woman who was incidentally diagnosed as having a right renal tumor by ultrasonography on February 18, 1982. The echogram showed a high echogenic mass in the right kidney, and the fatty density in the renal mass was determined by computed tomography. These patients underwent nephrectomy and the histological diagnosis was angiomyolipoma. The usefulness of ultrasonography and computed tomography in the preoperative diagnosis of this clinical entity and the possibility of association with renal cell carcinoma are discussed.
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PMID:[Two cases of renal angiomyolipoma]. 667 31

Three cases of renal angiomyolipoma are reported. The first case was a 53-year-old female with the complaint of left flank pain. In both cases selective angiography revealed a renal tumor, and computerized tomography disclosed a renal mass with low density corresponding to the fat tissue. From several examinations these two cases were preoperatively diagnosed as renal angiomyolipoma and nephrectomy was performed. Histopathological diagnosis was renal angiomyolipoma. The third case was a 64-year-old female with the complaints of left flank pain and macrohematuria. In this case computerized tomography revealed a renal mass which did not have a low density area. The possibility of renal cell carcinoma was considered and nephrectomy was performed. Histological diagnosis was renal angiomyolipoma which was primarily composed of smooth muscle cells. The first case had a calcified lesion in the brain. But there was no evidence of tuberous sclerosis in the following two cases. Some problems in diagnosis and treatment of renal angiomyolipoma are presented, and a statistical study is made on 194 reported cases of renal angiomyolipoma in Japan.
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PMID:[Angiomyolipoma of the kidney: report of three cases and a statistical study of 194 cases in Japan]. 673 Nov 98

Renal angiomyolipoma, a benign tumor, can involve regional lymph nodes. Although this phenomenon has been reported previously followup information has been scant. We have treated 3 patients who had renal angiomyolipoma with nodal involvement and all had further evidence of tuberous sclerosis. Each patient had hematuria with flank pain and required nephrectomy. In the ensuing 3 to 11 years none of these patients has had evidence of further disease progression. Nodal involvement may reflect the multicentricity of angiomyolipoma or may represent a form of "benign metastasis" but it does not appear to be a harbinger of disease progression.
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PMID:The significance of lymph nodal involvement in renal angiomyolipoma. 715 90

Imaging studies on six patients with known angiomyolipomas were reviewed to determine the contribution of each imaging modality to the preoperative diagnosis. A spectrum of clinical presentations from asymptomatic patients with tuberous sclerosis to acutely ill patients with flank pain and hypotension was included. Findings varied from multiple, small, bilateral intrarenal masses to single larger masses with extrarenal components. Computed tomography (CT) identified fat containing masses in all cases. Ultrasound showed hyperechoic masses in all four cases in which it was utilized. In addition, CT allowed diagnosis of associated hematomas and additional angiomyolipomas not seen on other studies. Ultrasound provided a noninvasive follow-up method without the use of ionizing radiation.
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PMID:Relative value of computed tomography and ultrasonography in the assessment of renal angiomyolipoma. 721 41

In 10 years the diagnosis of renal angiomyolipoma (RAML) was made in 14 patients (male-to female ratio 1:3.7) at our institution; 1 case was associated with tuberous sclerosis (TS) and 1 case had regional lymph node involvement. A statistical study was done on data taken from 739 cases of RAML in the Japanese literature, including our cases. The male to female ratio was 1 to 3. Twenty eight percent of the cases were associated with TS. The ratio of bilateral cases to the unilateral one was 1 to 3. The main clinical signs were flank pain, abdominal mass, hematuria and fever elevation. Recently the ratio of nephrectomy has decreased to 30%. The percentage of detecting the fat component by ultrasonography (US), computed tomography (CT) and magnetic resonance imaging were 88.1%, 86.5% and 80.8% respectively. The percentages of visualizing hypervascularity, aneurysms, absence of arterio-venous shunt and onion peel appearance by selective renal angiography were 77.3%, 71.4%, 48.1% and 4.9% respectively. Small (less than 3 cm), asymptomatic, simple lesions with adipose component may be observed annually by CT and US until more experiences is gained with surveillance of these patients. Embolization was useful for emergency cases or pre-treatment of nephron sparing surgery, but insufficient by itself. As there still remain problems in the diagnosis of RAML, especially in the case of very small tumors, in the case with almost no adipose component and in the case associated with renal cell carcinoma, the diagnosis of RAML should be made synthetically including angiography.
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PMID:[Renal angiomyolipoma: diagnosis and treatment]. 748 42

A 34-year-old woman with tuberous sclerosis presented with an increase of an abdominal mass and intermittent left flank pain on May 20, 1991. Computed tomography showed multiple bilateral renal masses with fatty density areas and a fatty density thrombus in the inferior vena cava, which extended through the right renal vein of the right kidney on ultrasonography. The inferior vena caval thrombus was also demonstrated by magnetic resonance imaging. Since marked deterioration of the right renal function was found on renography, right radical nephrectomy with thrombectomy was performed on July 2. Microscopically all tumors were identical with angiomyolipoma. She was discharged on Jury 20 and had been followed with good renal function at the outpatient clinic for more than 2 years. Follow up CT revealed no interval changes in the left renal masses.
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PMID:[Inferior vena caval tumor thrombus in a patient with renal angiomyolipoma associated with tuberous sclerosis]. 780 79

Bilateral renal angiomyolipoma is a rare entity, usually associated with tuberous sclerosis. Five cases of bilateral renal angiomyolipoma, all females, with a mean age of 34.6 years, are reported. All patients had symptoms attributable to lesions only on one side, with flank pain and mass the commonest symptoms encountered. Only one case had clinical evidence of stigmata of tuberous sclerosis. The mean size of the lesions on the symptomatic side was 17 cm, while that on the asymptomatic side was 2 cm. Three patients were diagnosed correctly as having angiomyolipomas preoperatively with the use of ultrasonography and computed tomography (CT); two of these were treated with total nephrectomy and the third with partial nephrectomy. The other two cases were seen before the availability of CT and were only diagnosed intraoperatively. Both patients were treated with total nephrectomy. The lesions on the asymptomatic side were kept on close surveillance. Two patients developed an increase in the size of the lesions in the contralateral kidney 1 year and 3 1/2 years after the first surgery. Both patients were treated with partial nephrectomy. All patients are alive at 3-14 years (mean 6.6 years) after operation.
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PMID:Bilateral renal angiomyolipoma. 806 55

Pulmonary lymphangioleiomyomatosis (LAM) is a rare disorder that affects women and can lead to serious respiratory impairment. Since Bourneville's tuberous sclerosis (TS) was first reported, the striking similarities between the two entities have led many to believe that LAM is a forme fruste of TS. This is suggested by reports that angiomyolipomas, rare tumours in themselves, are reported in 40-80% of TS patients and occur in 15-30% of LAM patients. A retrospective chart review was conducted of 14 patients that presented to our institution with a diagnosis of LAM. We sought to document the clinical manifestations, particularly the incidence and location of extrathoracic tumours, in order to further support the hypothesis that LAM is a forme fruste of TS. Twelve patients had premenopausal onset of symptoms and two postmenopausal. The diagnosis was confirmed histologically (n = 12) and/or by computed tomography (CT) scan of the thorax (n = 12). Imaging investigations revealed extrathoracic tumours in 12 of 14 patients (86%). Eight of the 14 patients (57%) had renal tumours consistent with angiomyolipomas (bilateral in five patients). Only one patient had renal symptoms (flank pain and haematuria). All had normal serum creatinine, one had a reduced creatinine clearance. Extrathoracic nonrenal tumours were discovered in the pancreas, adrenals and uterus, findings previously unreported in LAM. In summary, the incidence of extrathoracic tumours in lymphangioleiomyomatosis patients is much higher than previously reported in the literature. This increased association supports the theory that lymphangioleiomyomatosis and tuberous sclerosis represent part of a spectrum of a similar disease process.
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PMID:Extrathoracic angiomyolipomas in lymphangioleiomyomatosis. 872 95

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


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