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Query: UMLS:C0016199 (
flank pain
)
2,189
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
We describe the complex presentation of a patient with renal medullary carcinoma, a newly described entity primarily affecting young patients with sickle cell trait. Renal medullary carcinoma is an aggressive, rapidly destructive tumor associated with a delayed diagnosis and a poor outcome. The most common presenting signs and symptoms include hematuria, abdominal or
flank pain
, and weight loss. Sickle cell trait as the sole cause of hematuria in young black patients is a diagnosis of exclusion.
Hemoglobin
electrophoresis, intravenous pyelography, and computed tomography scans should be the minimal studies performed in young black patients with hematuria.
...
PMID:Renal medullary carcinoma in an adolescent with sickle cell trait. 992 68
A 20-year-old African American male presented with a history of left
flank pain
and passing of light pink urine. Medical history included sickle cell trait. Urine analysis was positive for protein and blood. Metabolic profile, autoantibody screen, and complement levels were normal.
Hemoglobin
electrophoresis revealed an 41.8% HbS diagnostic of sickle cell trait. Creatinine clearance was normal and proteinuria was nonnephrotic. A noncontrast computed tomography (CT) scan showed left proximal hydronephrosis. Urology follow-up was arranged and the differential included renal papillary necrosis, or renal cyst rupture. He presented 3 months later with sudden onset left
flank pain
and gross hematuria. Serum creatinine was 1.8 mg/dL. Computed tomography scan with contrast revealed innumerable lung lesions, an enlarged heterogenously enhancing left kidney, and retroperitoneal adenopathy. Ultrasound revealed an obstructed left collecting system and a 14-cm enlarged left kidney with no discrete mass. Testicular markers/ultrasound, upper/lower endoscopies were normal. Lung biopsy revealed poorly differentiated adenocarcinoma positive for cytokeratin 7. Renal, sarcoma, and gastrointestinal markers were negative. By exclusion, it appeared that the patient had a carcinoma of unknown primary. However, with the clinical and personal history, a diagnosis of renal medullary carcinoma (RMC) was made. RMC is a rare and highly malignant tumor that should always be included in the differential of a patient with sickle cell disorder and hematuria. Renal biopsy typically fails to sample the renal medulla and radiologic findings might not raise the suspicion of a renal tumor. Thus, clinical suspicion must always be high in order to preserve the patient's only chance of prolonged survival.
...
PMID:Adenocarcinoma of unknown primary in a 20-year-old African American male. 1969 25
We describe a rare case of methicillin-sensitive
staphylococcus aureus
(MSSA) septicemia with metastatic spread leading to pulmonary septic emboli, sub-capsular perinephric renal abscess, prostatic abscess, and intramuscular calf and gluteal abscess in a 48-year-old male with uncontrolled diabetes mellitus (
Hemoglobin
A1c of 15.2). The patient developed right lower extremity pain after a session of acupuncture followed by a three-week history of fevers, chills, abdominal pain, left
flank pain
, and urinary retention. Evaluation was negative for endocarditis, intracardiac shunt, intravenous drug usage, or immunodeficiency.
...
PMID:Unusual Infectious Metastases Secondary to Acupuncture Induced MSSA Septicemia. 3242 27