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

Renal leiomyomas large enough to be clinically diagnosed are extremely rare. We review 30 cases of clinically diagnosed renal leiomyoma from the literature in Japan, including our 2 new cases. Case 1: In a 52-year-old man with no symptoms a renal mass was found accidentally on an ultrasonogram. CT scan showed a mass with a cystic area at the upper pole of the right kidney. Angiogram showed a hypovascular mass. Case 2: CT scan revealed a cystic mass and angiogram showed an avascular mass at the upper pole of the left kidney in a 19-year-old man having gross hematuria and left flank pain. Transperitoneal nephrectomy was done in both cases. Histologically each tumor was composed of monotonous proliferation of spindle shaped cells without atypia, which showed intense immunoreactivity for alpha-smooth muscle actin. The diagnosis of benign leiomyoma was made in each case. In a review of 30 cases, we found that renal leiomyomas occur most often in female (77%), between decades 2 and 5 of life (median: 46 years). On the angiogram it appears most often as an avascular or hypovascular mass. CT scan shows cystic or mixed solid/cystic or solid lesion, occasionally with calcification. Preoperative diagnosis is extremely difficult to be made. Histologically, fibroma, angiomyolipoma, congenital mesoblastic nephroma and leiomyosarcoma should be differentiated.
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PMID:[Two cases of leiomyoma of the kidney]. 156 55

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

Often incidentally discovered, angiomyolipoma (AML) may be revealed by sudden flank pain secondary to perirenal hemorrhage. Tumoral vessels have an increased fragility, leading to potentially major blood loss. Diagnosis is based on the demonstration of a mass which is hyperechogenic by ultrasound and of partially negative density by CT scan. Our cases from 1979 to 1991 are reviewed. Clinical data, investigation and treatment are discussed. Although benign, this tumor may be associated with high morbidity.
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PMID:[Renal angiomyolipoma: benign tumor?]. 181 Oct 26

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 five year experience with spontaneous perirenal hemorrhage at the Brigham and Women's Hospital was reviewed, with 15 instances identified. Ages ranged from 17 to 80 years (mean of 56 years). Abdominal or flank pain was the presenting symptom in 13 patients; one patient was in a state of shock. Anemia and elevation of lactate dehydrogenase were uniformly present during acute evaluation. Computerized tomography (CT) identified lesions other than hematoma in ten of 14 instances. Arteriography was essential to the diagnosis of two vascular lesions not appreciated by other imaging modalities. Intravenous pyelography and ultrasound did not add significantly to findings on CT or arteriography. Six patients underwent serial CT evaluation; three with persistent nonfatty lesions had carcinoma of the kidney confirmed at operation. Carcinoma of the kidney occurred in a total of eight patients and angiomyolipoma in three patients. It was suggested that patients with clinical evidence for spontaneous perirenal hemorrhage should be evaluated by CT, with arteriography added when the underlying cause remains uncertain. Nephrectomy should be performed for CT evidence of nonfatty lesions other than hematoma. Other patients may have serial CT with nephrectomy reserved for persistent abnormalities. The protocol decreases the likelihood of nephrectomy for benign disease while addressing the high incidence of carcinoma of the kidney among patients with spontaneous perirenal hemorrhage.
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PMID:Rational approach to evaluation and management of spontaneous perirenal hemorrhage. 230 Aug 64

We describe a 37-year-old female with bilateral renal angiomyolipoma. She visited the Emergency Department at our hospital because of right severe flank pain. Computed tomography (CT) disclosed a bilateral renal tumors with fat components and high density lesions compatible with a hematoma. Conservative treatment was started, resulting in the improvement in laboratory findings and symptoms. Needle biopsies were performed under the guidance of ultrasonography. The histology was renal angiomyolipoma. She has been receiving a follow-up study at our out-patient clinic with an uneventful course.
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PMID:[A case of bilateral renal angiomyolipoma diagnosed by fine needle biopsies]. 280 89

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


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