Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since the initial report in 1973 of 7 women who developed liver tumors while using oral contraceptives (OCs) over 300 cases have been reported. Hapatic tumors associated with OCs are benign (focal nodular hyperplasia or hepatocellular adenoma) or malignant (hepatocellular carcinoma, angiosarcoma, or cholangiocellular carcinoma). Mestranol is the main estrogen related to the development of hepatic adenoma but other OCs containing combinations of ethinyl estradiol, ethyl estradiol, mestranol, norethynodrel, norethisterone, and norgestrol are also associated with the tumors. Longterm OC users have an estimated annual incidence of 3-4/100,000. Hepatic tumors may present with abdominal pain or be an incidental finding on physical examination or at laparotomy. Diagnosis is confirmed by scintigraphy, echography, CT-scanning, angiography, or laparoscopy. Dynamic isotopic scanning may help differentiate between benign and malignant lesions. Symptomatic benign tumors and malignant tumors are best treated by partial hepatectomy and a ban on estrogens. The use of OCs should be forbidden following resections. Surgery is indicated for patients with persistent or recurrent pain, those with intraperitoneal hemorrhage and those in whom a carcinoma is suspected. The administration of synthetic estrogens to experimental animals results in a variety of morphological and functional changes within the hepatocyte. Other possibilities are that the estrogen potentiates the carcinogenicity of other compounds, either by changing their metabolism or by interfering with their excretion due to the cholestatic effects of synthetic estrogens.
 ...
PMID:Oral contraceptives and hepatic tumors. 708 79

This study included 128 superficial lobe parotid tumours seen over a 27-year period. Using data stored in a prospective manner the sensitivity and specificity of regarding every lump in the tail of the parotid as being either a pleomorphic adenoma or other benign tumour was assessed. We found that 71% of all lumps in the tail of the parotid with no facial palsy were pleomorphic adenomas, sensitivity 0.88 and specificity 0.50. We also found that 96% of lumps in the tail of the parotid with no facial palsy, pain, trismus or fixation were benign, sensitivity 0.91 and specificity 0.84. We feel this information is useful in managing elderly patients and those reluctant to undergo surgery. It provides additional evidence as to the nature of the tumour and can be considered with the results of fine needle aspiration cytology (if available).
 ...
PMID:Reliability of clinical examination in the diagnosis of parotid tumours. 752 60

We report 50 examples of an uncommon type of renal adenoma from the files of the Armed Forces Institute of Pathology. They appear to be benign tumors with no malignant potential, and their chief importance is related to the fact that they are most often misinterpreted as renal cell carcinoma or epithelial Wilms' tumor. They predominated in females by well over 2:1. The mean age of the patients was 41 years, with a range of 5 to 83 years, and the mean size was 5.5 cm, with a range of 0.3 to 15.0 cm. Presenting signs and symptoms included pain in 11, hematuria in five, and palpable mass in five. In 20 patients the tumors were found incidentally during evaluation for other problems, and in six the other problem was polycythemia. This finding establishes a higher incidence of polycythemia in renal adenoma than in other previously reported renal diseases. Also of preoperative importance is the fact that these tumors are more commonly calcified than other renal neoplasms. Microscopically, these tumors consist of very small epithelial cells that form very small acini in an acellular stroma. Less often, they form tubular, glomeruloid, or polypoid and papillary formations. Most also show evidence of regression in the form of scarring and calcification. These lesions seem histogenetically related to epithelial Wilms' tumor, and, in fact, the two may occur together. They are histologically very similar to the metanephric hamartomatous element of nephroblastomatosis.
 ...
PMID:Metanephric adenoma. Clinicopathological study of fifty patients. 757 69

A 46-year-old woman with rheumatoid arthritis had been on non-steroidal antiinflammatory agents for eighteen years until she developed cushingoid features and hypertension resistant to antihypertensive drugs. She had high plasma cortisol and 24 h urinary 17-hydroxycorticosteroids (17HCS) which were not suppressed by 8 mg dexamethasone per day for two days. The circadian rhythm of plasma cortisol was absent and plasma ACTH concentrations were suppressed before and after intravenous administration of CRH. Abdominal computed tomography demonstrated a tumor (3.0 x 3.0 x 2.3 cm) in the right adrenal gland and a 131I-6 beta-19-nor-methylcholesterol scan revealed marked uptake on the same side. The patient underwent a right adrenalectomy and the diagnosis of a cortisol secreting benign adenoma was histologically confirmed. Blood pressure declined and cushingoid features regressed, but three months after the operation and while the patient was on replacement, she complained of pain on motion, marked tenderness and swelling of fingers, wrists, elbows, knees and foot joints, and had very high rheumatoid factors. Treatment with immunosuppressive drugs and oral and intraarticular administration of glucocorticoids were necessary to relieve the clinical symptoms of rheumatoid arthritis. In summary, we report a patient with rheumatoid arthritis and Cushing's syndrome due to an adrenal adenoma, in whom rheumatoid arthritis was exacerbated after curing the Cushing's syndrome. This suggests that it is imperative to follow the development and/or course of autoimmune diseases after the treatment of Cushing's syndrome.
 ...
PMID:Exacerbation of rheumatoid arthritis after removal of adrenal adenoma in Cushing's syndrome. 762 66

Recognition of the pathogenesis of secondary forms of hypertension is often considered the key to appropriate choice of treatment. We here present the results of a prolonged clinical follow-up (from 1 to 20 years) of a large number of patients with mineralocorticoid excess syndromes (MES), including over 100 patients with primary aldosteronism (PA), 3 cases with dexamethasone-suppressible aldosteronism (DSA), 3 cases of apparent mineralocorticoid excess (AME) Type II, and 4 patients with 17-hydroxylase deficiency (17OHDS). The patients with PA have been divided in two subgroups, one of 69 cases followed between 1973 and 1982, and the second of 37 patients studied between 1983 and 1992; 33 further cases were not evaluated due to poor compliance. In group I, 26 patients underwent surgery (23 unilateral adenoma, 1 primary hyperplasia, 2 bilateral nodular hyperplasia); at 5 years 50% had normal blood pressure, 25% had mild hypertension and 25% had moderate to severe hypertension. Forty-three patients with either adenoma (APA) or idiopathic aldosteronism (IHA) received long-term spironolactone treatment. Among them, 13 required the addition of thiazide and/or beta-blockers, while 13 were switched to an amiloride/thiazide combination (+/- beta blockers) due to side-effects to spironolactone (gynecomastia 6/20 males, menstrual upset or breast pain in 7/23 females). In group II, 12 patients underwent surgery (11 adenoma, 1 primary hyperplasia) with a similar outcome at 3 years as in group I; 25 patients were put on either K canrenoate (11) or Ca++ channel blockers (14) with or without KCl supplementation; in 8 cases these two drugs were combined according to blood pressure levels achieved during the follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Long-term treatment of mineralocorticoid excess syndromes. 779 22

Forty-three patients with secondary or autonomous hyperparathyroidism complicating chronic renal failure (CRF) underwent total parathyroidectomy (PTX) (follow-up 2-18 years, mean 8.7 years). Five were on conservative treatment for CRF, 35 on regular dialysis, and only three had a functioning allograft. At PTX, the most frequent findings were uncontrollable hypercalcaemia, musculo-skeletal pain, radiographic changes in the phalanges, and raised plasma parathyroid hormone (PTH) concentration. Pre-operatively, all patients were loaded with dihydrotachysterol or 1-alpha-OH cholecalciferol. Postoperatively, they were maintained on tapering doses of the same drugs and, briefly, oral calcium supplements. Five glands were identified and removed in two patients, four in 35 patients, three in three patients and only two in one patient. All had changes of hyperplasia and adenoma formation, except for one with a parathyroid carcinoma. Prompt symptomatic and radiographic improvement occurred, with normalization of plasma calcium and alkaline phosphatase. Postoperative PTH levels were available in 33 patients (23 by intact PTH assay): they were persistently high in 10/33 (2/23 intact); normal in seven (6 intact); low in 11 (3 intact), and undetectable in four (3 intact). Thus, PTX was incomplete in the majority of patients. Following transplantation, 3/20 (3/18 intact) patients still had detectable PTH. Only one patient developed symptomatic recurrent parathyroid disease requiring re-operation, and complications were few. Small dosages of vitamin D continue to be required, but not calcium supplementation, and no clinical effects of possible adynamic bone have been noted. At later renal transplantation in 27 patients, an easily treatable, uncomplicated hypocalcaemia was noted in 33%.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Long-term follow-up after total parathyroidectomy without parathyroid reimplantation in chronic renal failure. 782 May 43

Adrenalectomy is usually performed through a transabdominal or a posterior approach. These approaches are associated with a painful syndrome postoperatively and long hospital stay. We report a series of five successful laparoscopic adrenalectomies, performed on: a 35-year-old male with a 5-cm right nonfunctioning tumor; a 32-year-old female with a 1.8-cm right aldosterone-producing adenoma; a 17-year-old female with a 4-cm right adrenocortical adenoma; and a 33-year-old female with bilateral 3.5-cm right and 4.5-cm left pheocromocytoma. Single right adrenalectomy lasted between 2 h and 2 h 30 min and bilateral adrenalectomy 5 h and 30 min. No transfusion was required. The hospital stay was between 3 and 4 days. This technique adequately removes adrenal tumors surgically and results in less postoperative pain and rapid recovery.
 ...
PMID:Technical aspects of adrenalectomy via operative laparoscopy. 783 13

The feasibility, safety and effectiveness of percutaneous computed tomography-guided ethanol injection (PEI-CT) was investigated in a patient affected by aldosterone-producing adenoma (APA). A 42-year-old male patient with typical features of hyperaldosteronism presented a solitary left adrenal adenoma measuring 2 cm, with a normal contralateral gland, evidenced by both CT scan and adrenal [75Se-19]-nor-cholesterol scintigraphy. After normalization of potassium plasma levels, 4 ml of sterile 95% ethanol with 0.5 ml of 80% iothalamate sodium was injected. The procedure was completed in about 30 min. No severe pain or local complication was noted. Five hours after PEI, a fourfold and a twofold increase in aldosterone and cortisol plasma levels were observed, respectively. After 11 days on a normal sodium and potassium diet, normal potassium plasma levels and reduced aldosterone plasma levels were present, with reappearance of an aldosterone postural response. Plasma renin activity and aldosterone plasma levels normalized 1 month later, with reappearance also of a plasma renin activity postural response and maintenance of normal potassium plasma levels even on a high sodium and normal potassium diet. The patient has remained hypertensive, although lower antihypertensive drug dosages have been employed. After 17 months, normal biochemical, hormonal and morphological findings were still present. Thus, we suggest PEI-CT as a further alternative approach to surgery in the management of carefully selected patients with APA.
 ...
PMID:Percutaneous computed tomography-guided ethanol injection in aldosterone-producing adrenocortical adenoma. 788 78

Occasionally pancreatoduodenectomy is performed for clinically suspected pancreatic malignancy only for the surgeon to find that a benign aetiology accounts for the pancreatic mass. The aim of this study was twofold: to determine the incidence of pancreatoduodenectomy performed for a misdiagnosis of pancreatoduodenal malignancy and to identify potentially avoidable errors in preoperative and intraoperative judgement. Between 1956 and 1990, radical pancreatoduodenectomy was performed in 603 patients at the Mayo Clinic; 29 (5 per cent) underwent pancreatoduodenectomy for a diagnosis made before and during surgery of primary pancreatic or periampullary malignancy that was later proven histopathologically to be either unsuspected subacute or chronic pancreatitis (22 patients), benign fibrous common bile duct stricture (two), and penetrating duodenal ulcer, metastatic melanoma, ampullary adenoma, intrahepatic drug-induced cholestasis and pseudocyst (one each). No patient had a preoperative diagnosis of chronic pancreatitis. Weight loss, pain and/or jaundice were present in 27 of the 29 patients. Objective imaging tests, such as computed tomography, ultrasonography and/or endoscopic retrograde cholangiopancreatography, were performed in 25 patients. Potential errors in judgement may be avoided by a more aggressive attempt at biopsy in selected patients; in others, resection for presumed malignancy may be unavoidable.
 ...
PMID:Radical pancreatoduodenectomy for misdiagnosed pancreatic mass. 791 87

In 16 patients with unifocal thyroid autonomy suffering from hyperthyroidism and in 2 patients and euthyrosis 2-4 ml 96% alcohol was instilled to destroy the autonomous thyroid tissue while permanently monitoring the procedure by means of sonography. 17 of the patients were suffering from struma nodosa. Localization of the focally autonomous adenoma was possible, together with differentiation against concomitant thyroid nodes with normal or reduced function, by coinciding the findings obtained via colour Doppler sonography and scintiscanning. In one female patient local pain occurred during instillation that had to be alleviated by means of analgetics; there were no other noticeable side effects. 12 of 16 patients suffering from hyperthyroidism were euthyrotic 5 weeks after the first alcohol instillation; the thyrostatic dose had to be reduced in 4 patients. B-image sonography showed a reduction in size of the instilled adenomas and echo-poor and partly cystic transformation. Colour Doppler sonography revealed a marked reduction of internal vascularisation with preserved marginal vessels. Scintiscan control no longer visualised the autonomic foci (n = 10) or only with reduced activity (n = 7). Sonographically monitored on-target instillation of alcohol into autonomic thyroid adenoma is an effective, low-risk and low-cost procedure that can also be applied to outpatients by physicians well-versed in colour Doppler sonography and sonographic puncture technique. Colour Doppler sonographic localization of autonomic foci is methodically mandatory in patients suffering from struma multinodosa.
 ...
PMID:[Ultrasound-guided alcohol instillation in treatment of autonomous thyroid adenoma]. 797 83


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>