Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0016199 (flank pain)
 2,189 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-one patients with locally extensive and metastatic renal cell carcinoma were observed over an eight year period. At onset of the disease, symptoms due to metastatic deposits were the most frequent mode of presentation, followed by manifestation of local tumor growth (hematuria, flank pain or palpable mass) and paraneoplastic syndromes. Hormonal therapy with testosterone propionate, a progestational agent or both was assessed in 21 cases. Five instances of tumor regression, two involving recalcification of lytic osseous metastases, were documented. Endocrine studies to elucidate possible mechanisms of hormonal effectiveness were carried out in seven cases. Median survival from diagnosis was ten months. Following the rapid early mortality, a very gradual decrease in survival occurred, with 25% alive at ten years. Factors influencing survival include the duration of the interval between diagnosis of the primary tumor and appearance of metastases and the association of certain paraneoplastic syndromes.
 ...
PMID:Renal cell carcinoma: analysis of 31 cases with assessment of endocrine therapy. 61 Apr 16

ACKD is characterized by the development of many fluid-filled renal cysts and sometimes neoplasms in the kidneys of individuals with chronic renal failure but without a history of hereditary cystic disease. The condition is seen mainly in dialysis patients, but often begins in patients with ESRD before dialysis is started. Most patients with ACKD are asymptomatic, but the disorder may be associated with such serious complications as retroperitoneal hemorrhage and metastatic renal cell carcinoma. The diagnosis of ACKD and its complications is best achieved by CT scanning, although US and MR imaging may be useful in evaluation, particularly in patients not treated with dialysis. Cyst hemorrhage is common in ACKD and may cause flank pain and hematuria. Hemorrhagic cysts may be recognized by their CT scan, sonographic, or MR imaging features. Hemorrhagic cysts may rupture into the perinephric space causing large perinephric hematomas. These can usually be treated-conservatively. Patients with ACKD, particularly those treated with dialysis, have an increased risk of renal cell carcinoma. Renal cell carcinoma may also develop in the native kidneys of renal transplant recipients with good graft function many years after transplantation. Annual imaging of the native kidneys of all dialysis patients or of transplant recipients for the development of carcinoma is not justified, however, because it has not been shown to have a significant effect on patient outcome. Screening may, however, be useful in selected dialysis patients with good general medical condition and who have known risk factors for renal cell carcinoma including prolonged dialysis, large kidneys, ACKD, and male gender. Screening of the native kidneys of transplant recipients may be performed when they are referred for US evaluation of the renal allograft.
 ...
PMID:Acquired cystic kidney disease. 878 91

The development of molecular therapeutic agents has revolutionized the treatment of metastatic renal cell carcinoma, but the long-term complications of these novel medications are not yet well-defined. We report the case of a 61-year-old woman who presented with metastatic renal cell carcinoma to the liver and contralateral kidney and renal pelvis 6 years after nephrectomy. Treatment with four cycles of sunitinib malate resulted in an initial near-complete radiographic response. Subsequently, the patient presented with flank pain, acute renal failure, and hydronephrosis of her solitary kidney during her fourth cycle of treatment. A temporizing percutaneous nephrostomy tube was placed, and antegrade contrast studies showed a filling defect and complete distal ureteral occlusion. Ureteroscopy revealed ureteral obstruction by a soft-tissue mass. Pathologic examination demonstrated necrotic renal cell carcinoma, presumably due to sloughing of the previously identified renal pelvic metastasis. We discuss the implications of this unusual complication of complete ureteral obstruction from necrotic tumor in a patient with a near-complete response to sunitinib.
 ...
PMID:Metastatic renal cell carcinoma with partial response to sunitinib complicated by ureteral obstruction from necrotic tumor. 1838 63

Today the classic triad of flank pain, hematuria and a palpable abdominal mass is rarely present at initial diagnosis of renal cell carcinoma due to the growing number of cases diagnosed incidentally on imaging studies. We report a case of a 58-year-old female who presented with melena where a subsequent esophagogastroduodenoscopy demonstrated a bleeding duodenal lesion. Pathologic study of a biopsy revealed Clear Cell RCC and an ensuing abdominal CT revealed the direct duodenal invasion of a primary renal mass. We also provide a brief review of nephrectomy in the face of metastatic renal cell carcinoma.
 ...
PMID:Renal cell carcinoma presenting with Melena from direct invasion into the duodenum: a case report and a review of literature. 2462 Apr 13