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At least 883 records · Page 49Linked to original sources
PubMed1976

A clinicopathologic and prognostic study of epithelial tumors of the renal pelvis.

The aim of the present investigation was to assess the prognosis of epithelial pelvic tumors and evaluate from multivariate analysis the influence of different morphologic and clinical factors on the prognosis. The basic data are derived from the Swedish national series of patients with epithelial renal pelvic tumors diagnosed by histologic examination during 1962-63. Ninety-four of the 102 patients studied had a urothelial pelvic tumor and eight had an epidermoid carcinoma. The corrected 5-year survival rate was 51% in the curatively operated series, 60% among the males and 33% among the females. Infiltration depth was found to be of significant importance for the 5-year survival and thus a strong predictor for prognosis. Furthermore, each tumor grade and tumor structure exerts some influence on the prognosis independent of the infiltration depth. Nine patients had verified, and 16 patients had suspected phenacetin abuse and/or renal papillary necrosis. The survival rate was low and the relative frequency of females was high in this group of patients. These data may indicate a poorer prognosis in patients with phenacetin abuse, and may explain the sex difference in 5-year survival. Thirty-eight per cent of the patients with urothelial tumors of the renal pelvis had a synchronous or asynchronous tumor elsewhere in the urinary tract. The high frequency of local recurrence as well as the high frequency of infiltrating tumors and multiple tumors indicate the necessity for a more extensive operation such as perifascial nephrectomy with total ureterectomy including a cuff of the bladder.

Adult↗
PubMed1982

Analgesics and cancer of the renal pelvis in New South Wales.

A lifetime history of analgesics and tobacco consumption was obtained by a questionnaire completed at interview from 67 patients with carcinoma of the renal pelvis (40 women, 27 men) and 180 control subjects drawn from two sources, friends of patients and persons attending a health screening clinic. Regular consumption of analgesics conferred a tenfold relative risk of renal pelvic cancer in women and in men a risk ratio of 4-8. The fraction of cases for which analgesic consumption was an attributable risk was 0.74 in women and 0.43 in men. The effect of tobacco, much less than that of analgesics, was significant only in women (risk ratio approximately four; attributable risk 0.4), and no dose-response relationship was demonstrated. Relative excess risks suggested a synergistic effect when both analgesics and tobacco had been consumed. Standardized risk ratios indicated a dose-response relationship for both phenacetin-containing and non-phenacetin analgesics: moderate consumption doubled the risk of renal pelvic cancer, and heavy consumption increased at risk to 6-16 times that for noncomsumers.

Age Factors↗
PubMed1987

Regional chemotherapy with the use of cisplatin and doxorubicin as primary treatment for advanced sarcomas in shoulder, pelvis, and thigh.

Eight patients who had large sarcomas in the hip, thigh, or shoulder girdle have been described. Three had osteogenic sarcomas, and one each had Ewing's sarcoma, biphasic synovial sarcoma, pleomorphic liposarcoma, undifferentiated spindling sarcoma, and malignant fibrous histiocytoma. All eight tumors showed evidence of regression after intraarterial infusion of cisplatin and Adriamycin (doxorubicin) given over 48 hours at 3-week intervals, for a total of between three and seven courses. Tru-cut needle biopsy specimens of five of the lesions were normal after chemotherapy. However, after resection of the regressed fibrotic tumor in seven of the patients, four contained foci of probably viable malignant cells. These cell foci were intraosseous in three cases and in the wall of a cyst in one case. In the remaining case, tumor in the distribution of the infused artery regressed, but tumor in a region supplied by an artery that was not infused continued to enlarge. In one patient with osteogenic sarcoma in the pelvis, despite a good response to intraarterial chemotherapy that was followed by surgical resection and radiotherapy, tumor recurred in an adjacent area in tissues supplied by an artery not infused. A hindquarter amputation subsequently was required. With the exception of the two cases in which adequate tumor arterial infusion was not achieved, local primary tumor control was accomplished by intraarterial infusion chemotherapy followed by local resection or radiotherapy and local resection in all patients. Four patients are well without evidence of residual or metastatic sarcoma 3.5 years after presentation in the case of an osteogenic sarcoma of shoulder, 2.5 years after presentation in the case of a large pleomorphic liposarcoma of thigh and groin, 20 months after presentation in the case of lower-thigh malignant fibrous histiocytoma, and 1 year after presentation in a child with an osteogenic sarcoma of lower femur.

Adolescent↗
PubMed1988

Multicentric papillary adenocarcinoma of the renal pelvis and ureter. Report of a case with ultrastructural study.

A case of multicentric papillary adenocarcinoma arising in the renal pelvis and proximal ureteral mucosa of a 35-year-old man is presented. The left nephrectomy specimen demonstrated multiple, fungating, papillary tumors. The largest tumor measured 10 X 9 X 6 cm and invaded the renal parenchyma. Smaller tumors with long stalks were found. Microscopically, the papillary fronds of each neoplasm were lined by a single layer of cuboidal to low columnar epithelium admixed with a few areas of invasive tubular adenocarcinoma. The adjacent pelvic mucosa was the site of cuboidal epithelial metaplasia. The ultrastructure of both the papillary tumor and the pelvic mucosa suggested that they originated from the nonmucigenic metaplastic epithelium with a partial similarity to the lining of the proximal convoluted tubule. The growth pattern and the multicentric development of this unusual neoplasm suggest that this is a case of the malignant counterpart of the nephrogenic adenoma in the kidney and ureter, and reflect a biologic behavior corresponding to ordinary urothelial papillary tumors.

Adenocarcinoma, Papillary↗
PubMed1989

Flow DNA analysis in the characterization of carcinoma of the renal pelvis and ureter.

A prospective study comprised operative specimens from 11 patients with transitional cell carcinoma of the renal pelvis or ureter. DNA analysis of the primary tumor and of multiple biopsy specimens from preselected sites of the surrounding urothelium was performed with flow cytometry. All Grade 3 tumors and 50% of the Grade 2 tumors were aneuploid, and the remainder were Grade 2 and diploid. All invasive tumors were aneuploid. Carcinoma in situ was found in some of the preselected biopsy specimens, all of which were aneuploid, from two patients. Close correlation thus was observed between aneuploidy and tumor invasiveness, whereas diploidy was seen only in noninvasive tumors with lower malignancy grade. Aneuploidy was also associated with increased risk of carcinoma in situ. The study indicated that DNA analysis may be useful for defining the malignant potential of urothelial tumors of the upper urinary tract more fully than conventional grading and staging permit.

Adult↗
PubMed1991

Hepatoid adenocarcinoma of the renal pelvis producing alpha-fetoprotein of hepatic type and bile pigment.

A right renal pelvic mass in a 72-year-old man was resected. The histologic appearance of the tumor was a mixture of tubular adenocarcinoma cells and hepatoid neoplastic cells, and there was a resemblance to hepatoid adenocarcinoma. The intraoperative level of serum alpha-fetoprotein (AFP) was calculated to be 2246 ng/ml, and the postoperative level ranges from 183.6 to 285.6 ng/ml. Lectin binding assays showed that the serum AFP was the hepatic carcinoma type. In a hepatoid portion, an iron-negative, brown to green pigment was positive for bile. Alpha-fetoprotein was immunohistochemically evident in the neoplastic cells. In addition to the hepatic differentiation, the tumor had differentiated into intestinal absorptive or pancreatobiliary tract cells, as deduced from the frequent presence of spicular bodies, a unique light microscopic feature equivalent to microvilli with an actin core. The hepatoid adenocarcinoma is a distinct type of AFP-producing carcinoma present in the organs with epithelium of endodermal origin. Hepatoid adenocarcinoma in the renal pelvis may arise from a metaplasia of neoplastic mesonephric cells into endodermal cells.

Adenocarcinoma↗
PubMed1993

Transitional cell carcinoma of the renal pelvis and ureter in Taiwan. DNA analysis by flow cytometry.

BACKGROUND: The incidence of upper urinary tract tumors is relatively high in southern Taiwan. DNA analysis by means of flow cytometry is not well investigated with regard to tumors of the upper urinary tract and the differences in DNA ploidy between transitional cell carcinomas in endemic and nonendemic areas. METHODS: A retrospective nuclear DNA ploidy analysis by flow cytometry comprised 41 formaldehyde solution-fixed, paraffin-embedded tissue specimens of transitional cell carcinoma of the renal pelvis and ureter. The preparation of nuclear suspensions from paraffin-embedded tissue blocks and staining were modified by means of the techniques of Hedley and Vindeløv. RESULTS: There was no statistical correlation between DNA ploidy, histologic grade, and pathologic stage, however, 82% of the DNA nondiploid tumors showed tumor progression. In contrast, only 46% of the DNA diploid tumors revealed tumor progression. Among Grade 2 tumors, 85% of the DNA nondiploid tumors showed postoperative tumor progression, whereas only 31% of the DNA diploid tumors showed tumor progression. Seventy-nine percent of the nondiploid patterns were present in patients native to the Pa Chang Valley, where the so-called "blackfoot disease" and urothelium tumor are endemic, whereas only 22% appeared in patients living in other areas. CONCLUSIONS: DNA flow cytometry can identify a group of patients with poor outcome unpredictable by pathologic examination, and is an important tool in research into the pathogenesis of cancer.

Carcinoma, Transitional Cell↗
PubMed1976

The systemic arterial pattern of the guinea pig: the pelvis and pelvic limb.

The systemic arterial pattern of 59 guinea pigs was examined by dissection, angiography, or corrosion casting. The blood supply to the pelvis and the pelvic limbs arises as two terminal branches of the aorta, the right and left common iliac arteries, and each of these divides into external and internal iliac arteries. Their pattern of distribution resembles a typical mammalian pattern. The external iliac artery passes throught the body wall to supply the pelvic limb and the internal iliac artery is distributed primarily to the pelvic region and its viscera.

Abdomen↗
PubMed2005

A newly recognized syndrome involving limbs, pelvis, and genital organs or a variant of Al-Awadi/Raas-Rothschild syndrome?

We report on a 3-year-old Thai boy with limb, pelvic, and genital malformations. The combination of findings found in this patient is similar to that of Al-Awadi/Raas-Rothchild syndrome (AARRS) or limb/pelvis hypoplasia/aplasia syndrome. The upper limbs are more severely affected than the lower ones. Unlike that of AARRS, the radial ray is more severely affected than the ulnar ray. The presence of humeroulnar synostosis and humero-ulnar-radial synostosis and the absence of a radius distinguishes it from AARRS. The similarities and dissimilarities between the features in the present patient and other limb-pelvic hypoplasia/aplasia syndromes are discussed. The findings in this group of patients appear to demonstrate limb-pelvis-genital organ developmental field defects.

Abnormalities, Multiple↗
PubMed1976

Carcinoma of the renal pelvis: an analysis of the diagnostic problems in 23 cases.

A series of 23 patients with carcinoma of the renal pelvis is presented. The different presentations are described and discussed, and the difficulties in establishing a preoperative diagnosis are considered. There were 3 squamous cell carcinomas in the series, all of them associated with renal stone and urinary tract infection.

Adult↗
PubMed2003

Anatomy of the arcus tendineus fasciae pelvis in females.

Because of its proximity to the urethra, the anterior part of the arcus tendineus fasciae pelvis (ATFP) may be used in urethrosuspension procedures for urinary stress incontinence. In this study, 10 embalmed female cadaver hemipelves were dissected and their gross anatomy described. In females, the ATFP is a condensation of the endopelvic fascia. The anterior attachment of the ATFP is to the caudal inner surface of the body of the pubic bone at a site averaging 4 mm lateral to the pubic symphysis and covering an average area of 53 mm(2). Posteriorly, it attaches to the medial surface of the ischial spine. In nine of the 10 hemipelves the first anterior centimeters of the ATFP have a clear lateral fixation either to the lateral part of the levator ani muscle (n = 1), to the fascia covering the obturator internus muscle (n = 7), or to the obturator membrane (n = 1). Medially from the ATFP derives a 2-3-cm long flat fibrous attachment to the posterolateral aspect of the urethra. In eight unembalmed cadavers, the ATFP gave way at a pulling force of 8.2 kg (range = 3.5-11.5 kg). The ATFP resists caudal movement of the proximal anterior vaginal wall and the urethra in the upright posture and, therefore, may be suitable for urethrosuspension procedures.

Adult↗
PubMed2001

Clinical anatomy and the physical examination part I: thorax, abdomen, perineum, and pelvis.

This paper by the Educational Affairs Committee of the American Association of Clinical Anatomists (AACA) is a sequel to one published earlier, "A Clinical Anatomy Curriculum for the Medical Student of the 21st Century: Gross Anatomy" (AACA. 1996, Clin Anat. 9:71-99). In that curricular document a number of clinical procedures that apply gross anatomy to current medical practice are cited, including procedures related to the physical examination. This paper describes numerous anatomically based procedures that are performed during a physical examination to demonstrate that (1) gross anatomy forms a fundamental basis for physical diagnosis and (2) such an anatomic basis is delineated in our previously published curricular document. The AACA Educational Affairs Committee also hopes that the examples presented here will serve as a starting point for incorporating elements of the physical examination within a clinical anatomy curriculum in gross anatomy at the medical school level. This paper focuses on the physical examination of the thorax, abdomen, perineum, and pelvis; a subsequent paper will treat the physical examination of the limbs, back, head, and neck.

Abdomen↗
PubMed1993

Different roles for phenacetin and paracetamol in cancer of the kidney and renal pelvis.

A population-based case-control study of kidney cancer was carried out in New South Wales using data from structured interviews with 489 cases of renal-cell cancer and 147 cases of renal pelvic cancer diagnosed in 1989 and 1990, together with 523 controls from the electoral rolls. This study showed that the risk of renal pelvic cancer was increased by phenacetin/aspirin compound analgesics (RR = 12.2; 95% CI 6.8-22.2) to a far greater extent than by paracetamol (RR = 1.3; 95% CI 0.7-2.4; not significant). There was a doubling of risk (RR = 2.0; 95% CI 0.9-4.4) in the highest tertile of paracetamol taken in any form compared with values for non-users of any type of analgesic. By contrast, the risk of renal-cell cancer appeared to be increased to a similar degree by phenacetin/aspirin compound analgesics (RR = 1.4; 95% CI 0.9-2.3) and paracetamol taken in any form (RR = 1.5; 95% CI 1.0-2.3). When both drugs were treated as alternative forms of the same risk factor, the risk was increased by 1.7 (95% CI 1.2-2.4). On this evidence, we postulate that phenacetin/aspirin compounds are weakly carcinogenic in the renal parenchyma through the metabolic conversion of phenacetin to paracetamol, and potently carcinogenic in the renal pelvis by different or additional pathways involving renal papillary necrosis. In addition, there is an indication of a weak link between paracetamol and renal pelvic cancer.

Acetaminophen↗
PubMed1995

Analgesics and cancers of the renal pelvis and ureter.

To evaluate renal pelvis and ureter (RPU) cancer risk in relation to lifetime use of analgesics, a population-based case-control study was carried out in 3 areas of the United States. Among 502 cases and 496 controls diagnosed and interviewed during 1983-1986, no significant increases in risk were found for any of the non-prescription and prescription analgesics evaluated or among regular users of phenacetin, acetaminophen or aspirin. Neither cumulative lifetime ingestion nor duration of regular use of these 3 drugs, whether alone or in combination, was associated with significantly increased risk of RPU cancer, although a slight excess was observed among long-term users of acetaminophen. Risk was not increased among persons reporting highest cumulative dose and/or longest duration of phenacetin use. Although our study of RPU cancer is the largest to date, it was nonetheless limited by the small number of regular analgesic users and the relatively low response rates. Because of the relatively recent onset of widespread use of acetaminophen, its pharmacologic similarity to phenacetin, a known urothelial carcinogen, and the elevation in risk seen in long-term users, further surveillance of this analgesic is warranted.

Acetaminophen↗
PubMedDate not supplied

Ultrasound evaluation of the posthysterectomy pelvis.

Ultrasound findings in pelvic examinations of 80 patients with a previous hysterectomy are evaluated. Ovaries were located low in the pelvis close to the superior end of the vagina in a large number of patients. An enlarged ovary contiguous with the superior end of the vagina may simulate the appearance of the uterus. Occasionally, the superior end of the vagina or cervical remnant (in patients with a supracervical hysterectomy) may be prominent and should not be mistaken for a pathologic mass.

Adult↗
PubMedDate not supplied

MR imaging of the pelvis with an endorectal-external multicoil array.

Magnetic resonance (MR) images of the pelvis obtained with an endorectal coil have improved resolution relative to that of body coil images; however, they have limited spatial coverage. The sensitivity profile can be improved by using the endorectal coil combined with an external anterior coil as part of a multicoil array. If each coil is connected to a separate receiver, the individual images can be combined to provide an optimal signal-to-noise ratio (S/N). The authors have investigated a 5-inch (12.7-cm) surface coil or a two-coil array as the anterior coil. In both of these configurations, the S/N is improved relative to that of the endorectal coil alone at distances greater than 3 cm from the endorectal coil. The anterior two-coil array provides more lateral coverage. The improved spatial coverage available with this technique expands potential clinical applications of endorectal MR imaging.

Female↗