Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.01 seconds)

During the last 54 years at the Children's Hospital 11 children (10 female, 1 male) had been treated for an extragonadal germ cell tumor arising in the retroperitoneum. There were eight teratomas (five mature, three immature), two endodermal sinus tumors and one tumor with a mixture of both components. Abdominal pain or discomfort was the usual presenting complaint, with the average age at diagnosis being 18 months. On physical examination, each child had a palpable abdominal mass usually localized in the upper quadrants. The finding of calcification, bone or teeth, on radiologic study was most helpful in establishing a preoperative diagnosis of teratoma. The preferred treatment for children with mature and immature teratomas is complete surgical resection; decisions regarding adjuvant therapy for patients with immature tumors must be evaluated on an individual basis. The prognosis remains guarded for children with unresectable primaries or those with endodermal sinus tumor. Of three tumor-related deaths, two were due to metastatic endodermal sinus tumor and one resulted from extensive local growth by immature teratoma. Successful management of children with endodermal sinus tumor requires surgery aimed at debulking or complete resection in combination with aggressive adjuvant chemotherapy.
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PMID:Retroperitoneal germ cell tumors in childhood. A clinical and pathologic study of 11 cases. 298 49

A case of sweat gland carcinoma arising in a mature cystic teratoma in a 63-year-old woman is reported. The patient was admitted with the complaint of a lower abdominal pain. Under the diagnosis of a mature cystic teratoma of the right ovary, the tumor was removed. Histologically, adenocarcinoma was found in the wall of the mature cystic teratoma. A part of the tumor showed a differentiation of the secretory portion and duct of the sweat gland. Histochemically, sialic acid containing mucoprotein was defected. Electron microscopically, the tumor cells were found to have secretory granules and intracytoplasmic canaliculi. Therefore, the tumor was diagnosed as a sweat gland carcinoma arising from a mature cystic teratoma.
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PMID:[A case of sweat gland carcinoma arising in a mature cystic teratoma of the ovary]. 361 9

Forty-one patients with pure immature teratoma of the ovary treated at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston from 1944 to 1985 were reviewed. The median age of these patients was 17 years. The most common symptom was abdominal pain, which occurred in 39 (95%) patients. FIGO stages included 24 patients with stage I, four with stage II, 12 with stage III, and one stage IV. The tumors ranged in size from 6 to 31 cm in greatest diameter, with a median of 17 cm. Of 39 cases reexamined microscopically, four were grade 1 tumors, 22 were grade 2 tumors, and 13 were grade 3 tumors. Initial surgery included ovarian cystectomy in one patient, unilateral salpingo-oophorectomy in 27 patients, and bilateral salpingo-oophorectomy in 13 patients. Fifteen of 16 patients treated with surgery alone developed recurrent disease; 11 are surviving after further therapy. Two patients died after treatment with radiotherapy plus chemotherapy. Twenty-one patients received a combination of vincristine, actinomycin-D, and cyclophosphamide postoperatively, and 18 are alive and well. One of two patients who received other combination regimens is alive and well. Therefore, 29 of the 41 patients (71%) are alive and well. Optimal management of patients with pure immature teratoma of the ovary consists of initial surgery (with preservation of a normal contralateral ovary in most patients) followed by combination chemotherapy in all patients except those with stage I, grade 1 disease; the latter may be treated safely with surgery alone.
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PMID:Immature teratoma of the ovary. 376 73

Obstructive biliary disease in childhood is not common, but should be considered in the differential diagnosis of a child with jaundice, abdominal pain, or an abdominal mass. We have reviewed the experience at Vanderbilt Children's Hospital from 1970 to 1985, during which 87 children 18 years of age or younger with biliary tract disease were seen. Twelve patients (14%) had congenital disorders including choledochal stenosis, Caroli's disease, choledochal cyst, teratoma of the common hepatic duct and common bile duct, congenital septate biliary tree, and isolated atresia of the distal common bile duct. Thirty patients had neonatal cholestatic syndromes, and 37 had calculous disease of the gallbladder or extrahepatic bile ducts. Three patients had obstruction of the common bile duct caused by fibrosing pancreatitis. Two had sclerosing cholangitis. Obstruction of the common bile duct was caused by metastatic neoplasm in three patients. We discuss principles of diagnosis and management.
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PMID:Spectrum of biliary disease in childhood. 377 60

Successful treatment of three cases of malignant ovarian teratoma is reported. The first manifestation was abdominal pain in all cases. An abdominal mass was palpated in one patient only. Ultrasonography and computerized tomography could not supply an exact preoperative diagnosis. The initial therapy was unilateral salpingo-oophorectomy. Peritoneal implants were present in all three cases. The implant was malignant in two children and peritoneal resection was performed. Further treatment consisted of combined chemotherapy with actinomycin, adriamycin, vincristin and cyclophosphamide according to a modified T2 protocol. Radiation therapy was also applied to the entire abdomen. The favourable results may be attributed to this aggressive combined treatment, which may improve prognosis.
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PMID:Malignant ovarian teratoma in childhood. 664 11

Sixty-three patients (15 months to 17 years of age) with ovarian tumors were seen. Fifty-six patients had germ cell tumors and 7 epithelial tumors, 6 patients had bilateral tumors, 47 patients had teratomas (41 benign, 3 with embryonic tissue, and 3 malignant), 6 germinomas, 1 endodermal sinus tumor, and 2 mixed germ cell tumors. Of the patients with epithelial tumors, six had cystadenomas and one cystadenocarcinoma. Abdominal pain was the most common symptom, and an abdominal mass the most common sign. A calcification on abdominal films was seen in 29 patients with benign teratoma. At surgery, the opposite ovary was bivalved or biopsied in 31 patients with benign tumors. Two patients had teratomas burried in the ovarian tissue. Among 47 patients with benign tumors, 37 have remained well after the operation and 10 were lost to follow-up. Two girls with embryonic teratoma are well 71 and 19 months after diagnosis but the third died with embryonal carcinoma. Of the 13 patients with malignant tumors, 8 are alive disease free 4 1/2 to 17 years after diagnosis, 4 are dead, and 1 is lost to follow-up (disease free 15 months after diagnosis).
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PMID:Benign and malignant ovarian tumors in children and adolescents. A review of 63 cases. 670 5

Over a five-year period, we treated 16 children ranging in age from 8 weeks to 16 years for ovarian masses. The most frequent clinical manifestation was abdominal pain and/or mass. Ultrasonography correctly localized the lesion and delineated its nature in nine of ten cases. Operation in 15 showed teratoma (six benign, two malignant), endodermal sinus tumor (two), dysgerminoma (two), follicular cyst (two), and leukemic ovarian infiltrate (one). Adnexal torsion was present in three. Three children had tumor metastases at initial operation. Resection of the tumor with conscious preservation of uninvolved pelvic structures was performed if possible. For unresectable tumor, debulking was undertaken. Multiagent chemotherapy was used for all malignant tumors. Survival was 94%. The proper therapy for ovarian lesions in children requires familiarity with the unique nature of these lesions, as well as consideration of future endocrine and reproductive function.
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PMID:Ovarian masses in the child and adolescent. 687 88

Eighteen men presenting with metastatic germ-cell malignancy in whom no primary tumour could be palpated in either testis are described. All patients had both testes in the scrotal sac and none had a history of maldescent. All had abdominal node involvement, in most cases associated with metastases at other sites. Ten men presented with Stage 4 disease, five with Stage 3 and three with Stage 2. The most common histological sub-type associated with an occult primary testicular tumour was trophoblastic malignant teratoma (9/18 patients). Abdominal pain (12 patients) and systemic symptoms (10 patients) were common presenting features. There was a history of testicular atrophy in eight patients and seven had experienced episodes of transient testicular pain up to 18 months before presentation. In three of four patients in whom the testis was examined histologically following a history of atrophy and/or pain, there was evidence of a primary tumour, manifest as spontaneous tumour regression (one), differentiation (one) or a small micro-primary trophoblastic teratoma (one). In a fifth patient an ultrasonic scan showed a 1-cm echogenic mass in an atrophic testis. In 10 patients the diagnosis of germ-cell malignancy was established by laparotomy. Obstructive uropathy was present in six patients, associated with haematuria in four patients.
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PMID:Occult germ-cell testicular tumours. 688 52

Three cases of primary trabecular carcinoid tumor of the ovary are reported. In two cases the tumor was a pure trabecular carcinoid, while the third it was associated with mature cystic teratoma. The patients were aged 36, 48 and 56 years. The presenting symptoms were lower abdominal pain and the presence of a lower abdominal mass. In one case the tumor was found incidentally. There was no evidence of metastases or carcinoid syndrome in any of these cases. The treatment was bilateral salpingo-oophorectomy and hysterectomy in two cases and bilateral salpingo-oophorectomy in one case. All the patients are well and disease-free for periods ranging from 4-13 years after surgery. The pathology, differential diagnosis and behavior of this entity are discussed and reviewed. Primary trabecular carcinoid of the ovary is an uncommon ovarian tumor, behaving like a tumor of low malignant potential. In the younger patient the treatment is unilateral salpingo-oophorectomy, while in the postmenopausal patient bilateral salpingo-oophorectomy and hysterectomy is the treatment of choice. Long-term follow-up is advisable.
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PMID:Primary trabecular carcinoid tumor of the ovary. 710 79

A 68-year-old woman presented a one-month history of lower abdominal pain and weight loss, and was admitted to our hospital. On physical examination, a large hard mass was palpated in her right lower abdomen. An ultrasonograph and computed tomographic (CT) scan revealed a right ovarian tumor that measured 6.9 x 4.9 cm in size. A total hysterectomy and bilateral salpingo-oophorectomy were performed. The postoperative diagnosis of the tumor was squamous cell carcinoma (SCC) of the ovary. She died of infection and disseminated intravascular coagulation 5 months after surgery. The clinical and autopsy examinations did not show the primary lesions of SCC except in the right ovary. Mature cystic teratoma, Brenner tumor and endometriosis, which are ordinary regarded as the histogenesis of ovarian SCC, were not found, but a few surface epithelial inclusion cysts with squamous metaplasia were observed in non-cancerous area of the right ovary, and the contiguous transition from the metaplastic cyst wall to SCC was confirmed by stepwise serial sections. The present case suggests that the surface epithelium of ovary could be the fourth possibility in the histogenesis of the ovarian SCC.
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PMID:Squamous cell carcinoma of the ovary--a case report. 770 49


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