1/575. Successful treatment of a patient with stage IV rhabdoid tumor of the kidney: case report and review.The clinical course of a 31-month-old patient with advanced (stage IV) rhabdoid tumor of the kidney (RTK) and an analysis of treatment variables that may impact survival are presented. Treatment included complete resection of abdominal disease, radiation therapy to the abdomen and chest, and chemotherapy on a schedule of dose intensification by reduction of the interval between cycles. Inclusion of doxorubicin in treatment was associated with survival among patients in published series (P = 0.002). The patient was in continuous complete remission 60 months from diagnosis. Stage IV rhabdoid tumor of the kidney can be effectively treated with intensive multimodal therapy. doxorubicin may be an important component of a successful therapeutic regimen.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/575. Classical congenital mesoblastic nephroma in an adult: a case report on an Ethiopian.A 54-year-old Ethiopian woman presented to Tikur Anbessa Hospital with left flank pain and left renal tumour mass in October 1996, and biopsy from nephrectomy specimen was reported as classical congenital mesoblastic nephroma (CMN). The clinical presentation, laboratory data and the pathologic findings of the patient are described in detail. In ethiopia, there is no report of congenital mesoblastic nephroma of adulthood. In this report, the clinical presentation and the pathological features of congenital mesoblastic nephroma are also reviewed from available literature.- - - - - - - - - - ranking = 12.208633707043keywords = pain (Clic here for more details about this article) |
3/575. Giant retroperitoneal angiomyolipoma. A case report.We discuss a case of a giant renal angiomyolipoma. A 28 year-old woman presented with a history of a painless and swelling abdominal mass. A computerized tomography (CT) scan of the abdomen demonstrated a 27 x 13 x 11 cm tumor in the right retroperitoneum. At laparotomy, a wide excision of the mass was performed and the histopathological examination of the resected specimen revealed the presence of an angiomyolipoma. The clinical, radiological and pathological findings of this case are reported with a review of the literature.- - - - - - - - - - ranking = 12.208633707043keywords = pain (Clic here for more details about this article) |
4/575. Renal fibrohistiocytic sarcoma. Three cases and a review of the literature.The purpose of this paper is to report three unpublished cases of so-called "renal malignant fibrous histiocytoma" which should be more appropriately called "renal fibrohistiocytic sarcoma", and to review and analyze the data concerning 41 cases collected from the literature and our three new cases, making a total of 44 cases. Our third case is very interesting; in addition to the fact that this condition is rare, this particular patient also had concomitant nonmalignant ascites and compression of the descending colon, both conditions being rarely associated with renal cancer. The average age of the patients was 58 years; in 66% of the cases the tumor involved the left kidney; 57% of the patients were males; the average tumor size was 12 cm; nephrectomy was performed in 93% of the cases; the average survival was 16 months. In none of the cases was a preoperative diagnosis correctly made. It is concluded that a triad of symptoms and signs (renal pain, weight loss, and large tumor size) as well as a triad of imaging characteristics (areas of low density on the CT scan, hypoechoic areas on ultrasound, and hypovascularity on angiography) may hold the promise of a preoperative diagnosis. It is suggested that the tumor arises from the system of Gerota's fascia-renal capsule.- - - - - - - - - - ranking = 12.208633707043keywords = pain (Clic here for more details about this article) |
5/575. Metastatic spine disease in renal cell carcinoma--indication and results of surgery.Metastatic spine disease is frequent in renal cell carcinoma and 50% of osseous metastases are already found at the time of primary diagnosis. Therefore patient mobility and quality of life are threatened early in the course of disease. Surgery is able to relieve pain and to regain or to preserve mobility. Indication and technique of surgery (anterior decompression, vertebral replacement and transpedicular fixation) are explained and treatment results of eleven cases are reported. All patients with paraparesis or cord compression preoperatively were mobile when leaving our hospital after surgery. There were no severe complications, especially no neurological deteriorations or deaths. Postoperative survival time was ten months approximately in cases with multiple osseous lesions and it was several years in cases with solitary metastases. Mobility was preserved for most of the survival time. In conclusion, restabilisation of the spine proved to be a worthwhile treatment option in well-selected cases suffering from malignant spinal involvement.- - - - - - - - - - ranking = 12.208633707043keywords = pain (Clic here for more details about this article) |
6/575. Metanephric adenofibroma: report of a case and review of the literature.The recent recognition of a variety of pediatric renal tumors of different biologic behavior places an ever-increasing demand on the surgical pathologist for an accurate diagnosis. Although metanephric adenofibroma is one of the rarest benign renal tumors, the clinical importance of correctly diagnosing it cannot be overemphasized because it can potentially be mistaken as Wilms' tumor. We describe the clinical, radiologic, and pathologic features of a case of metanephric adenofibroma and discuss its differential diagnosis. The neoplasm was composed of two discrete components: a major fibroblastic element and a minor immature epithelial element. The latter formed a small nodule beneath the renal capsule, which could barely be detected by magnetic resonance imaging. This subcapsular nodule, however, was slightly soft and tan and was distinctly different from the white, whorled cut surface of the main tumor. It was formed by closely packed small immature epithelial cells in a slightly edematous background, which was histologically identical to metanephric adenoma and closely resembled epithelial Wilms' tumor. Unlike Wilms' tumor, however, the epithelial cells were very bland with no mitoses. The main bulk of the tumor was formed by spindle fibroblastic cells that were cytologically similar to the spindle cells in congenital mesoblastic nephroma. The tumor, however, was well demarcated without the irregular infiltrating edges of congenital mesoblastic nephroma. In contrast to the randomly distributed epithelial element throughout the stromal component in previous reported cases of metanephric adenofibroma, our finding of the exceedingly small and discrete epithelial component expands the known histologic spectrum of the disease. In addition, the presence of such minute epithelial nodule underscores the importance of diligent pathologic examination and careful sampling of tissue for histologic examination.- - - - - - - - - - ranking = 0.67213141900032keywords = back (Clic here for more details about this article) |
7/575. Renal cell carcinoma in an intrathoracic kidney: radiographic findings and surgical considerations.Ectopic intrathoracic kidney is a rare phenomenon and is usually an incidental finding on a chest radiograph. Of all intrathoracic kidneys, congenital ectopia is most often shown, with a traumatic etiology occurring much less frequently. We report a case of an ectopic intrathoracic kidney with associated renal cell carcinoma. Management, which was based on current treatment recommendations for isolated renal masses, consisted of radical nephrectomy. The patient has been without evidence of disease recurrence for 36 months after surgery.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
8/575. myelolipoma of the renal sinus. An unusual site for a rare extra- adrenal lesion.Extra-adrenal myelolipomas are rare; approximately 36 cases have been reported to date. We document a case of myelolipoma presenting as a localized mass in the renal sinus of a 66-year-old man. The chief clinical and radiologic differential diagnostic considerations in this case included a malignant renal tumor arising in the hilum. The patient was being investigated for recurrent urinary tract infections and vague abdominal pains. Histologically, the lesion showed features characteristic of a myelolipoma. There was also marked chronic inflammation in and around the mass. The uneventful follow-up of 62 months is in keeping with the benign nature of this lesion. This report expands the possibilities of the differential diagnoses of renal hilar neoplasms, particularly in view of the increased use of imaging techniques that are bound to detect many incidental lesions in this region.- - - - - - - - - - ranking = 23.311658129112keywords = pain, abdominal pain (Clic here for more details about this article) |
9/575. Renal cell carcinoma: a rare source of cauda equina metastasis. Case report.The authors present the case of a patient in whom intradural metastasis from renal cell carcinoma spread to the cauda equina. To the authors' knowledge, this is only the second report of its kind. This male patient had undergone nephrectomy for the treatment of renal cell carcinoma for 5 years and was diagnosed as having metastatic lung disease 1 year prior to admission. The patient presented with lower back pain that radiated to both legs, but he exhibited no sensorimotor deficits. The majority of cauda equina tumors are primary tumors, and metastases are very rare. The literature is reviewed with reference to current molecular genetic paradigms of metastatic renal cell carcinoma.- - - - - - - - - - ranking = 20.888789626768keywords = pain, back pain, back (Clic here for more details about this article) |
10/575. angiotensin ii type 1 receptor expression in two cases of juxtaglomerular cell tumor: correlation to negative feedback of renin secretion by angiotensin ii.The angiotensin ii (Ang II) type 1 (AT1) receptor is highly expressed on juxtaglomerular (G) cells and is assumed to be involved in the negative short loop feedback regulation of renin secretion and in the suppression of Ang II-mediated JG cell proliferation and/or growth. However, as JG cell tumor is rare, expression and pathophysiological significance of AT1 receptor expression in JG cell tumor remain unknown. In the present study, we investigated renin responses to various treatments, including the angiotensin converting enzyme inhibitor captopril, and correlated the results with AT1 and Ang II type 2 (AT2) receptor mRNA expression levels in two cases of JG cell tumor. Whereas plasma renin activity (PRA) did not show any significant change in Case 1, it was increased by 72% in Case 2 in response to captopril challenge. In concordance with these results, AT1 receptor mRNA was not detected in tumor tissue of Case 1 but was clearly demonstrated in the tumor of Case 2. AT2 receptor mRNA expression was not detected in either of the cases. In contrast to captopril challenge, PRA was suppressed by 30% in Case 1 and 42% in Case 2 in response to saline infusion, and was increased by 230% in Case 1 and 59% in Case 2 in response to furosemide-upright posture for 2 h. These results suggest that the short loop feedback inhibition of renin secretion by Ang II in JG cell tumor is closely related to AT1 receptor expression levels in the tumor tissue. In addition, the result suggested that despite its autonomy, renin secretion from JG cell tumor is still under physiological regulatory control.- - - - - - - - - - ranking = 4.0327885140019keywords = back (Clic here for more details about this article) |
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