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

In a prospective study, 26 patients (18 women, 8 men; mean age 74 [51-92] years) with clinically and biochemically confirmed hyperthyroidism and autonomous thyroid nodules, as proven by scintigraphy and colour Doppler ultrasound (CDUS), the nodular tissue was destroyed by alcohol injection. All patients had multinodular goitre, eleven with solitary adenoma and 15 with two or more adenomas. Under continuous CDUS monitoring 2-4 ml of 96% ethanol per injection were instilled in a total of 87 sessions (mean of 3.3 injections per patient). Minor side effects (pressure sensation, pain, reddening) occurred with five injections. The effect of the treatment was a reduction in size and cystic degeneration of the nodule, as well as decreased vascularization as demonstrated by CDUS. A euthyroid state was achieved, without any additional thyrostatic drugs, within 5 weeks in 18 of the 26 patients, while in eight the initial carbimazole dosage could be reduced to a quarter. After 6 weeks 11 nodules had become scintigraphically inactive. In 12 patients the technetium uptake had been reduced and initially suppressed paranodular tissue again showed functional activity. These observations indicate that the described method is an efficacious and cost-effective out-patient procedure with few side effects for the treatment of hyperthyroidism associated with single or several autonomous thyroid nodules. The localization of the hyperactive adenomas should be done together with scintigraphy and CDUS.
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PMID:[Color Doppler sonography-guided percutaneous alcohol instillation in the therapy of functionally autonomous thyroid nodules]. 773 53

Adrenalectomy is usually performed via transabdominal or posterior approaches. Unfortunately, both approaches are associated with painful postoperative syndromes. Recently, laparoscopic surgery was applied to organ removal. During a period of 12 months, we performed a series of successful laparoscopic adrenalectomies (10 of the right and 11 of the left gland). The pathologies were medullary cyst (1), angiomyolipoma (1), DHEAS hyperplasia (1), primary aldosteronism (2), Cushing's adenoma (3), pheochromocytoma (4), Cushing's syndrome (4), and nonfunctional adenoma (5). A flank approach was taken with four 11-mm trocars. Electrocautery and blunt forceps were used for dissection. The vessels were secured with medium-large titanium clips, and the adrenal was removed in a sterile plastic bag. The average operating time was 2.3 h, and median postoperative stay was 4 days. Two patients required blood transfusion of 2 units postoperatively. We believe this technique is adequate for the surgical removal of adrenal tissue, resulting in less postoperative pain and in rapid recovery. It may also change the surgical management of asymptomatic adrenal lesions.
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PMID:Laparoscopic adrenalectomy. The importance of a flank approach in the lateral decubitus position. 816 86

A patient with asymptomatic primary hyperparathyroidism who spontaneously became normocalcemia is reported. The only significant finding was that of pain and tenderness in the enlarged parathyroid gland 2 weeks prior to surgery. This was due to a recent infarction of a parathyroid adenoma.
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PMID:Spontaneous infarction of parathyroid adenoma: case report and literature review. 825 67

Between June and September 1993, laparoscopic adrenalectomy was indicated in five patients (three women, two men; aged 25-50 years). Three had a phaeochromocytoma, two had an adenoma (Conn's syndrome). Four of the five tumours were localized to the right adrenal gland, one to the left. Tumour diameter ranged from 3 to 5 cm. The laparoscopic procedure was successful in four of the patients (three right, one left). In the fifth case the operations had to be completed by conventional surgery, because of non-controllable haemorrhage. Duration of operation ranged between 165 and 360 min for right adrenalectomy and was 135 min for the left one. Rapid convalescence, lower dose of pain-killing drug required, short hospital stay and good cosmetic results characterized the postoperative course after the laparoscopic procedure. This technique thus opens up new perspectives for adrenal surgery.
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PMID:[Laparoscopic adrenalectomy]. 826 27

Nine children (6 boys, 3 girls) were diagnosed with a primary endobronchial or pulmonary parenchymal neoplasm. The average age at diagnosis was 9 years. Presenting complaints included cough (7), fever (5), pulmonary infection (3), respiratory distress (3), weight loss (2), pain (2), and hemoptysis (1). Pulmonary x-rays showed persistent atelectasis, pneumonic infiltrates or mass lesions. A computed tomography scan was performed in 8. Five of six endobronchial tumors were diagnosed with bronchoscopy and biopsy. Treatment consisted of thoracotomy and pulmonary resection in 7 cases and laser resection in 2. The pathologic diagnoses were bronchial carcinoid (3), bronchial mucoepidermoid carcinoma (1), inflammatory pseudotumor (plasma cell granuloma) of the bronchus (2) and of the lung parenchyma (1), fibrosarcoma (1), and rhabdomyosarcoma (1). Postoperative chemotherapy was given only to the patient with pulmonary rhabdomyosarcoma; this child died. One child has developed a local recurrence while 7 children are alive and free of disease at an average of 2.4 years postresection. Pulmonary neoplasms are unusual in the pediatric age group and represent a wide spectrum of pathology. Including the present series, 383 tumors have been described. Seventy-six percent were malignant. Early investigation and surgical intervention are essential in children with persistent pulmonary symptoms or x-ray abnormalities. In most cases, the prognosis is excellent with complete surgical resection; however, malignancies other than bronchial adenoma are associated with significantly mortality.
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PMID:Childhood primary pulmonary neoplasms. 830 77

A 43-year-old woman had left midfacial pain and a left intranasal mass. Pathologists from three different institutions agreed that the biopsy specimens from the mass represented squamous cell carcinoma. The final pathologic diagnosis made from the resected specimen was pleomorphic adenoma of the septum. This report describes a case which was initially misdiagnosed on the basis of misleading tissue biopsy results, but the excised tumor was finally diagnosed as pleomorphic adenoma. Otolaryngologists treating an intranasal mass must be aware of the difficulty of correctly diagnosing the initial tissue biopsy specimen in order to guard against unnecessary radical surgery.
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PMID:Septal pleomorphic adenoma masquerading as squamous cell carcinoma. 831 59

Thyroid adenoma is commonly associated with surgery and radiometabolic treatment; recently, according to previous successful reports, percutaneous ethanol injection therapy under sonographic guidance, has been introduced as an alternative. This technique has already been favourably used in the treatment of focal lesions, such as liver cancer and hyperparathyroidism. In our experience, we have treated with such therapy 69 patients affected by thyroid adenoma (55 females, 14 males; 28 pretoxic, 41 toxic). Ethanol (0.5-2.8 mL/mL nodular tissue) was injected, under sonographic guidance, in 4-9 sessions (1 weekly). Thyroid hormone profile was assessed during treatment and at 3 and 6 months follow-up. Apart from local transient pain in 21% sessions, two cases of pyrexia (38.5 degrees-1 day) and 3 cases of transient dysphonia, no relevant adverse effects were observed. A slight thyroid hormone increase was seen in both groups immediately following treatment. Six months after therapy a biochemical and clinical remission of hyperthyroidism was observed in 33 out of 41 toxic patients (80%); a significant increase of TSH levels was seen in both groups (p < 0.001). With follow-up, significant volume shrinkage (70-80% volume reduction--p < 0.0001) as well as structural alterations of the nodule, were consistently recorded at sonography, in both groups; a linear relationship (p < 0.0001) between pretreatment volume and volume reduction was found. At scintiscan functional activity of extranodular parenchyma was found in 75% of patients affected by pretoxic adenoma and in 63.1% of patients with toxic adenoma. These data confirm that percutaneous ethanol injection therapy is effective in obtaining functional ablation and in inducing remission of hyperthyroidism, when present; so it represents a valid and safe alternative to standard therapeutic tools of thyroid adenoma.
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PMID:[Treatment of hyperfunctioning thyroid adenoma: current trends]. 833 Apr 72

Spontaneous hemorrhage of a parathyroid adenoma is a rare occurrence which may manifest with a variety of symptoms including cervical pain, hoarseness, respiratory distress, and dysphagia. We report a case of an elderly woman with a parathyroid adenoma diagnosed 10 years ago and for which she had refused surgery. Throughout this period her hypercalcemia was carefully monitored, and she experienced no symptoms or adverse sequelae from her disease. However, the patient subsequently presented with a 1 day history of a sore throat and a nonproductive cough followed by the acute onset of dysphagia. At this time she was found to have an anterior neck hematoma extending to the midthorax. Computerized tomography and direct laryngoscopy were suggestive of the diagnosis and neck exploration confirmed the presence of a large hematoma beginning at the site of the 3 x 4 cm parathyroid adenoma and extending into the left strap musculature. We report this case of spontaneous hemorrhage of a cervical parathyroid adenoma to bring to mind a rare etiology of acute pharyngoesophageal dysphagia.
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PMID:Acute pharyngoesophageal dysphagia secondary to spontaneous hemorrhage of a parathyroid adenoma. 843 23

Over a 5-year period (1985 to 1990), 25 patients (11 men and 14 women, median age 68) with adenomatous tumors of the papilla of Vater judged to be benign by endoscopic appearance and forceps biopsy were included in this study. All patients had de novo tumors except for two patients who had recurrent adenomas after local surgical excision. Presenting symptoms included pain (19 patients), jaundice (9 patients), and pancreatitis (4 patients). ERCP showed bile and pancreatic duct dilation in 20 patients (6 with stones) and 2 patients, respectively. The adenoma and the papilla of Vater were excised using a standard polypectomy snare (snare papillectomy). Procedure-related complications included bleeding in two patients and acute pancreatitis in three patients. No deaths occurred. Histologic analysis showed benign adenoma with mild to moderate dysplasia in 18 patients and severe dysplasia in 1 patient. Two patients with evidence for intraductal tumor extension on ERCP were referred for surgery. Six patients had recurrences at a median follow-up of 37 months (range, 7 to 79 months), of whom one had intraductal tumor spread and underwent pancreatoduodenectomy. Five patients were re-treated endoscopically; one ultimately required surgery.
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PMID:Endoscopic snare excision of benign adenomas of the papilla of Vater. 849 50

The outcomes of treatment with intravascular embolization/chemoembolization and regional chemotherapy were analyzed in 862 patients with tumors of the kidney (n = 568), urinary bladder (n = 232) and prostate (n = 62). In renal cancer, the five-year survival rates after mechanical embolization followed by nephrectomy were 51%, those after chemoembolization and surgery, 77%. In inoperable cases, they were 3 and 25%, respectively (p < 0.05). The findings with new procedures of iron drug embolization, followed by local hyperthermia, are much more promising. In 90% after regional arterial chemotherapy, symptoms (pain, dysuria, hemorrhage) of bladder cancer ceased. With embolization, successful hemostasis was performed in 80% of massive bleedings from the bladder tumor and significant reductions of blood loss were achieved after transurethral resection of prostatic carcinoma/adenoma. X-ray endovascular surgical techniques play an important role in the treatment of oncologic urological diseases.
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PMID:[X-ray intravascular surgery in oncologic urology]. 864 68


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