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)

Two unusual cases of pleomorphic adenoma (benign mixed tumor) of the trachea were found in a 56-year-old woman and a 20-year-old man. Both patients had been initially treated for presumed bronchial asthma for 5 years and 4 years, respectively. Pulmonary function tests in each showed typical extrathoracic obstruction. The diagnosis of tracheal lesions in both cases was based principally on the following: 1) dyspnea without complete remission over an extended period of time following initial examination; 2) marked retraction of the supraclavicular and suprasternal notches during inspiration with stridor on physical examination; and 3) a high degree of suspicion. Large tumors were found within the air column of the trachea by soft tissue density X-ray films and electroradiographs of the neck, CT scans of the neck and mediastinum in each patient revealed that the tumor originated from the membranous layers of the trachea in the woman and the posterolateral wall of the trachea in the man. Fiberoptic bronchoscopy confirmed the clinical diagnosis. Both cases were successfully treated by segmental resection of the trachea with end-to-end anastomosis.
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PMID:Pleomorphic adenoma of the trachea: report of two cases. 168 62

A 10-year-old black male with a 6-month history of progressive dyspnea and stridor was found to have a submucosal mass occupying 75% of the subglottic airway. Biopsy specimens showed a pleomorphic adenoma of minor salivary gland origin--a tumor with a predilection for local recurrence after resection. A tracheostomy was performed for airway control and the lesion was treated with endotracheal cryotherapy. Two months later, the tracheostomy was removed and the patient has remained asymptomatic for 9 years. Pulmonary function studies 2 years following cryotherapy demonstrated a forced vital capacity (FVC) of 81% predicted, and a forced expiratory volume-one second (FEV-1) of 73% predicted. Bronchoscopy with biopsy at 5 years showed no evidence of recurrent airway obstruction or persistent tumor. This represents the first reported case of successful treatment of an airway tumor in a child utilizing profound cryotherapy. The case illustrates the utility of endotracheal cryotherapy in the treatment of certain benign and malignant obstructing lesions of the airway in children.
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PMID:Successful cryotherapy of a benign tracheal neoplasm. 317 51

Eighty patients at the Massachusetts General Hospital underwent resection of substernal goiter in the years 1976 to 1982. Mean age of the 50 women and 30 men was 56 years, and 10 (19 percent) had undergone prior thyroid surgery. The most common symptoms were cervical mass (69 percent), dysphagia (33 percent), and dyspnea (28 percent); 13 percent were asymptomatic. On examination, cervical mass was present in most (90 percent) but not all patients, 51 percent were obese, and more than one third had tracheal deviation. Fifty-one of 52 patients tested were euthyroid and one was mildly hypothyroid. Chest radiographs showed tracheal deviation in 79 percent and soft tissue mass in 56 percent. Seventy-eight patients underwent resection through a cervical collar incision only; one had cervical incision plus upper partial sternotomy; and one required cervical incision plus full median sternotomy. Pathologic examination revealed multinodular goiter in 41 (51 percent), follicular adenoma in 35 (44 percent), and Hashimoto's thyroiditis in 4 (5 percent). Mean goiter weight was 104 g, and the mean greatest dimension was 9 cm. Occult papillary carcinoma was found in two patients. There were no deaths or major complications. Analysis of our data indicate the following: (1) Substernal goiter may exist in the absence of symptoms or signs. (2) Extensive radiologic evaluation and thyroid function testing are rarely required. (3) With rare exceptions, substernal goiter represents an extension of a cervical growth through the thoracic inlet and can be approached through a cervical collar incision. (4) Histologically, these are multinodular goiters or follicular adenomas, although Hashimoto's thyroiditis may occur. (5) Given the small but present risks of acute stridor or occult malignancy and the negligible surgical risk, operation should be recommended. (6) Patients should be followed since, with or without levothyroxine, goiters may recur.
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PMID:Substernal goiter. Analysis of 80 patients from Massachusetts General Hospital. 397 Mar 28

A 10-year-old uncastrated male Dalmatian dog was referred for gait abnormalities consisting of chronic progressive stiffness and rigidity. Other symptoms were polyphagia associated with weight gain, polyuria and polydipsia, excessive panting, and an inspiratory stridor. The owner had noticed progressive thickening of the skin and enlargement of the tongue over the last 3 years. Physical examination revealed thickening of the skin, redundant skin folds, and enlargement of the tongue. The only remarkable abnormalities found on routine laboratory examination were mild anaemia and an increased serum fructosamine concentration. Circulating concentrations of total thyroxine, free thyroxine, and cTSH, and the results of an ACTH stimulation test were all within reference ranges. The basal serum growth hormone (GH) concentration was markedly elevated (23microg/l) and did not decrease during a glucose tolerance test or after somatostatin administration. The serum insulin-like growth factor-1 concentration was also markedly elevated (1254microg/l). Basal serum insulin concentration was high (95mU/l) and insulin concentrations increased considerably after glucose loading, consistent with insulin resistance. Abdominal ultrasonography showed no abnormalities. Survey radiographs of the vertebral column showed severe spondylosis deformans extending from the cervical to the lumbosacral spine. CT scanning of the skull showed an enlarged pituitary gland with normal enhancement pattern. On post-mortem examination, the entire vertebral column appeared as a single and inflexible structure due to the presence of multiple fused osteophytes. The pituitary gland contained an acidophilic adenoma that immunostained positively for GH (and negatively for ACTH and alpha-MSH). In conclusion, this Dalmatian dog with acromegaly and insulin resistance represents the first case of GH hypersecretion proven to be due to a somatotroph adenoma.
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PMID:Acromegaly due to a somatroph adenoma in a dog. 1647 61

We present case report of primary hyperparathyroidism treated surgically as well as a review of literature concerning this subject. The disease of not well known etiology presents with elevated parathormon levels and hypercalcemia. Primary hyperparathyroidism which states 85% percent of all kinds of hyperparathyroidism is usually parathyroid adenoma, in 11-15% glandular hyperplasia and in 1-4% parathyroid cancer. Clinical symptoms are muscle weakness and fatigue, nephrolithiasis, occasionally peptic ulcers, pancreatitis, hypertension. Laboratory test reveal increased level of PTH, hypercalcemia, elevated alkaline phosphatase levels and decreased phosphorus levels. Diagnostic imaging techniques such as ultrasonography, MRI or CT have sensitivity about 52-75%. Highest sensitivity in localization of ectopic parathyroid adenoma has sestamibi scintigraphy with technetium-99. Skeleton x-rays show typical changes in distal parts of bones and osteopenia. Treatment of choice is surgical excision of adenoma. Normalization of PTH and calcium levels after surgery and improvement of renal, musculoskeletal and circulatory system function could be achieved in 95%. Most common complications are recurrent laryngeal nerve injury, hypo- or hyperparathyroidism, bleeding or stridor.
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PMID:[Primary hyperparathyroidism--case report and review of the literature]. 1682 51

A 71-year-old male was treated for suspected bronchial asthma because of dyspnea and stridor for 3 months before presenting at our hospital. Chest computed tomogram and a laryngotracheoscopy revealed a mass occupying the subglottic cavity. Instead of a laryngotracheal resection, the tumor was extirpated from the posterior wall of the subglottis and the first two tracheal rings successfully through a vertical tracheotomy just above the life-saving trachestomy tube, and was diagnosed as pleomorphic adenoma. The patient is alive and well with no recurrent tumor 12 years after surgery, without any effect on the function of the voice or swallowing.
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PMID:Transtracheal endoluminal resection of a pleomorphic adenoma occluding subglottis. 1892 13

We present a case of a 39-year-old female patient with acute stridor due to a large tumor located at the level of the upper third of her thoracic esophagus. Parathyroid gland tumors are unusual in the differential diagnosis of mediastinal tumors. This tumor was removed via a thoracocervical approach, which offers multiple advantages when used for tumors in this location. The eventual diagnosis on histology was parathyroid adenoma. The patient had no clinical evidence of metabolic abnormalities and her pre- and postoperative calcium and postoperative parathyroid hormone (PTH) levels were within normal limits. This case poses the interesting question of whether identification of elevated PTH levels is an absolute prerequisite for diagnosing parathyroid adenomas. It is an example of a difficult diagnostic and therapeutic problem.
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PMID:Airway obstruction due to giant non-parathyroid hormone-producing parathyroid adenoma. 1905 95

A 73-year-old woman underwent an uncomplicated focused parathyroidectomy for an adenoma. Immediately after extubation she developed respiratory distress and her airway became compromised. No obvious cause could be found for the stridor and no response was obtained from nebulised adrenaline (norepinephrine). An intravenous bolus of calcium provided immediate but temporary relief. Lasting relief was obtained following the administration of an intravenous calcium infusion. Serology later confirmed a small decrease in calcium concentrations but at the time of the respiratory compromise the values were still within normal range.
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PMID:Immediate post-parathyroidectomy stridor resolved with intravenous calcium. 2168 52

Primary parapharyngeal space (PPS) tumors are rare, representing only 0.5% of all head and neck neoplasms. About 80% of tumors of this space are benign, and 20% are malignant. They often pose therapeutic and diagnostic problems due to variable non-specific symptoms and the complex anatomy of this space. Pleomorphic adenoma is the most common benign tumor of this space. It presents as an asymptomatic mass causing mild bulging in the soft palate or tonsillar region, or fullness near the angle of the mandible in the neck. We report the case of a 60-year-old male admitted to the emergency department with breathing difficulty and acute stridor. He was unable to maintain oxygen saturation, and an emergency tracheostomy was performed. Radiological and cytological evaluation were performed, and the patient was diagnosed as having primary PPS pleomorphic adenoma. The tumor was excised via the transcervical approach. The rarity of tumor in this space and unusual life-threatening presentation prompted the authors to report this case. To our knowledge, this is the third case reported worldwide of a pleomorphic adenoma causing upper airway obstruction and acute respiratory failure.
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PMID:Giant Parapharyngeal Space Pleomorphic Adenoma Causing Acute Airway Obstruction. 2858 6