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)

Mucoepidermoid carcinoma of the liver is a rare variant of cholangiocarcinoma, containing both mucus-secreting glandular cells and squamous cells mixed in nests. We report a case of mucoepidermoid carcinoma of the liver in a 69-year-old woman who presented with a 1-week history of fever, chills, and right flank pain. On admission, she was not jaundiced, and under a provisional diagnosis of liver abscess, a pigtail catheter was inserted into the abscess cavity. We performed right hepatectomy and partial excision of the diaphragm 1 month later. Microscopically, the tumor was composed of solid and invasive nests of epidermoid and mucin-producing cells with desmoplastic stroma. The epidermoid component of the tumor contained intercellular bridges and individual cell keratinization. Alcian blue and Periodic acid-Schiff (PAS) staining confirmed that there was mucin in the cytoplasm of mucus-secreting cells. The tumor cells, intrahepatic bile ducts, and ductules were consistently reactive with cytokeratin (CK) 7 and negative for CK20. The adjacent nonneoplastic liver cells were CK 7-/CK20-, and P63 immunostaining was positive in the epidermoid cells. The tumor was diagnosed as mucoepidermoid carcinoma arising from the intrahepatic bile duct. Despite aggressive surgical treatment, the patient died of multiple liver metastases 4 months after the right hepatectomy.
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PMID:Mucoepidermoid carcinoma of the liver diagnosed as a liver abscess: report of a case. 1552 36

Pleomorphic leiomyosarcoma (PLMS) of the adrenal gland is a rare tumor in an unusual location. A primary PLMS of the left adrenal gland is reported in a 59-yr-old Mexican woman who presented progressive flank pain and weight loss. The tumor measured 16 cm in diameter, showed markedly pleomorphic and osteoclast-like giant cells, necrosis, and high mitotic activity (average 15 per 10 high-power fields). The phenotype was supported by light microscopy and corroborated by immunohistochemistry. The neoplastic cells were strongly positive for muscle-specific actin, desmin, vimentin, and p53. They were negative for CD34, HMB45, estrogen receptors, and S-100 protein. The percentage of Ki-67 positive neoplastic cells was 7.6%. DNA content analysis by flow cytometry showed that tumor was diploid, with a high level of apoptosis. Extra-adrenal primary sites of origin were clinically excluded. The patient developed local recurrence and liver metastases 12 mo after initial treatment. She then received adjuvant chemotherapy and radiotherapy and the metastasis was resected. Twenty-four months later, she is alive with no evidence of disease. This is the second case of adrenal PLMS reported. This case exhibited a high histologic grade, aggressive behavior, and p53 overexpression, but diploid DNA content.
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PMID:Pleomorphic leiomyosarcoma of the adrenal gland with osteoclast-like giant cells. 1600 Aug 50

A 59-year-old man presented with a 2-month history of left flank pain and a possibility of gross hematuria. Left renal cell carcinoma stage II was diagnosed and radical left nephrectomy was performed. Twenty-two months postoperatively, lung metastases were demonstrated and 6 x 10(6) units of alpha-interferon (IFN-alpha) were administered for 9 months, only to keep the sizes of the metastases unchanged. Thirty-four months after the operation, liver metastases and bone metastasis in the left sacroiliac joint were revealed. The combination cytokine therapy was performed with 1.4 x 10(6) U of interleukin-2 (IL-2) and 3 x 10(6) U of IFN-alpha for 16 weeks, and the left sacroiliac joint metastasis was treated with radiation therapy of 4 Gy per day for 7 days. Six months after the 16 weeks of immunotherapy, computed tomography and bone scintigraphy revealed that the metastases of the lung, liver and bone substantially disappeared and this complete response is still kept after 16 months.
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PMID:Multifocal metastases of recurrent renal cell carcinoma successfully treated with a combination of low dose interleukin-2, alpha-interferon and radiotherapy. 1635 57

We report a case of malignant pheochromocytoma recurred after debulking surgery. A 17-year-old male patient visited our hospital for right flank pain. He had not experienced palpitations, headache, sweating or weight loss. Level of urinary catecholamine and its metabolite increased above normal values and abdominal computed tomography showed a huge right adrenal mass. One month after debulking surgery, anterior mediastinal and multiple liver metastases were found. These tumors had no response to two conventional regimens of combination chemotherapy (cyclophosphamide, vincristine, dacarbazine and anthracycline; and etoposide and cisplatin). We treated the patient with sunitinib, a multiple tyrosine kinase inhibitor. The tumor showed very good metabolic response to the therapy. In patient with malignant pheochromocytoma, sunitinib might be one therapeutic strategy for malignant pheochromocytomas.
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PMID:Sunitinib, a novel therapy for anthracycline- and cisplatin-refractory malignant pheochromocytoma. 1926 67

A 50-year-old woman complaining of right flank pain visited our hospital. Computed tomography revealed adrenal gland tumor measuring 10 cm in diameter, and multiple bone and liver metastases. It was diagnosed as a malignant pheochromocytoma by means of endocrinological examination and metaiodobenzylguanidine scintigraphy. Although 8 courses of cyclophosphamide, vincristine and dacarbazine therapy were performed, the tumor grew larger gradually, and the bony pain progressed and became uncontrollable with oxycodone hydrochloride. After zoredronic acid and strontium-89 were administered, the bony pain reduced, and the opioid usage could be reduced. In accordance with disease progression, the bony pain progressed again, but the readministration of strontium-89 could diminish the pain again. To our knowledge, this is the first case of malignant pheochromocytoma which strontium-89 was administered, and was effective.
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PMID:[A case of multiple bony pain due to metastatic malignant pheochromocytoma successfully treated with strontium-89]. 2475 95

Case 1 : A 60-year-old man presented with right flank pain. A computed tomography (CT) scan revealed a large right renal tumor, multiple lung metastases, multiple liver metastases, and tumor thrombus of the right renal vein. These findings were strongly suggestive of renal cell carcinoma. The patient suddenly complained of dyspnea at night due to bilateral pulmonary embolism, and the patient died 11 days after onset. Needle necropsy showed that the tumors were squamous cell carcinomas of the renal pelvis. Case 2 : A 66-year-old man presented with macrohematuria. An abdominal CT scan revealed a right renal mass and liver metastasis. The differential diagnosis was between renal cell carcinoma and urothelial carcinoma. A renal biopsy revealed urothelial carcinoma of the renal pelvis. The patient died of the disease 3 months after initiation of chemotherapy with gemcitabine and cisplatin. We report these 2 cases to emphasize the importance of renal biopsy and thorough histological analysis for the determination of treatment strategies against unresectable renal tumors.
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PMID:[Renal pelvic tumor with difficult radiological diagnosis : a report of two cases]. 2489 59

Carcinosarcomas are biphasic tumors comprising epithelial and mesenchymal components. Primary carcinosarcoma of the kidney is extremely uncommon and accounts for <1% of all malignant renal tumors. Primary carcinosarcoma of the kidney generally occurs after the age of 60 and the majority of the patients are men. This is the case report of a 56-year-old male patient who presented with left flank pain. Ultrasonography and computed tomography (CT) revealed ureterohydronephrosis and a left distal ureteral stone (25 mm). Renal scan with diethylenetriamine pentaacetate and dimercaptosuccinic acid revealed a non-functional kidney and a left nephroureterectomy was performed. The pathological examination of the surgical specimen revealed high-grade multiple carcinosarcomas according to the Union for International Cancer Control and cancer staging according to the tumor-node-metastasis classification determined the disease as stage T3aN0M0. At 6 months, the patient was administered systemic adjuvant chemotherapy (CTx) due to widespread lung and liver metastases on 18F-fluorodeoxyglucose positron-emission tomography/CT. However, no response was achieved with systemic CTx. The precise histogenesis of this type of cancer has not been determined. Carcinosarcoma of the kidney is a biphasic tumor and its biphasic nature must be confirmed using immunohistochemical methods during pathological diagnosis. The mesenchymal components of sarcomatoid carcinomas must be verified by pathological examination. Metaplastic changes may have malignant potential but should not be considered as malignant lesions. The most significant histopathological parameter that supports the diagnosis of sarcomatoid carcinoma is the identification of transitional zones between the epithelial and mesenchymal cells. Carcinosarcoma is characterized by aggressive malignant potential and a poor prognosis. An effective curative method has not yet been established, with the exception of radical surgery. It is therefore recommended to perform efficient surgical excision with adequate surgical margins.
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PMID:Multiple carcinosarcomas of the kidney: A case report and review of the literature. 2546 97

A 20-year-old man presented to the department of neurology with diplopia, occipital headache and right flank pain for 1-week duration. CT of the brain revealed skull metastasis with heterogeneously enhancing dural-based mass lesion at the occipital region. Positron emission tomography revealed tracer avid soft tissue mass involving the upper pole of the right kidney with loss of fat planes with the inferior surface of the liver. Multidisciplinary team approach was discussed. He underwent palliative nephrectomy with lymph nodal mass excision. Biopsy from the renal mass was suggestive of primitive neuroectodermal tumour. He developed progressive liver metastases in spite of adjuvant chemotherapy denoting very aggressive disease.
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PMID:Primitive neuroectodermal tumour of the kidney presenting as diplopia secondary to skull metastasis. 3188 18