Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007097 (carcinoma)
 152,788 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the phase I study of maytansine at our institution, some activity was observed against breast carcinoma and melanoma. A phase II study was thus initiated to more thoroughly investigate the activity of this drug against these two tumors. In 33 evaluable patients with melanoma, no complete or partial responses were observed. Twenty-one evaluable patients with breast cancer were entered and only one response (partial) was seen. The toxicity was similar to that observed in the phase I study and consisted mainly of diarrhea, paresthesias, phlebitis, and flu-like symptoms. Myelosuppression was infrequent and was short-lived when it occurred.
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PMID:Results of a phase II study of maytansine in patients with breast carcinoma and melanoma. 37 3

Twenty-two patients were given progressively increasing doses of Cytembena to determine toxicity patterns and to establish a dosage which produces definite but clinically tolerable toxicity when the drug is given by intravenous injections in a 5-day intensive course. Toxicity consisted primarily of nausea, vomiting, arm pain, and transiently decreased renal function. At higher doses, an "autonomic-storm" phenomenon was observed consisting of hypertension, tachycardia, tachypnea, hyperperistalsis, frequent explosive defecation, facial flushing and paresthesias, and chest pain with accompanying ischemic EKG changes. There was no evidence of mucocutaneous, hepatic, or hematologic toxic effects. Toxicity was dose-related, first being recognized at a daily dose of 300 mg/m2 and becoming clinically intolerable at a daily dose of 475 mg/m2. No permanent damage was observed in any of the organ systems monitored. An acceptable treatment regimen for most patients is 400 mg/m2/day for 5 days. Patient discomfort can be reduced by dividing each day's dose into two intravenous injections given at an interval of at least 6 hours. Coronary artery disease and impaired renal function should be contraindications to Cytembena therapy, and caution should be employed in the patients with significant impairment of liver function. Two of 22 patients, both with far-advanced carcinoma and previous chemotherapy failures, showed a favorable objective response to Cytembena therapy. Phase II studies to assess the magnitude of the drug's antineoplastic activity seem warranted.
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PMID:A phase I study of cytembena. 94 91

Pleomorphic adenoma is the most common neoplasm of the parotid gland, generally presenting as a slowly enlarging, firm, well-circumscribed, painless nodule. Occasional cases have presented after a short period of rapid growth or have been associated with pain. The vast majority of these tumors are solid, but rare examples have been associated with cystic degeneration or hemorrhage. Spontaneous and tumor-associated infarction of the parotid has been reported, but these examples have been limited to infarctions of Warthin's tumors and postoperative infarctions of salivary glands. We present the case of a 48-year-old male with a one-year history of a painful, enlarging, left parotid mass associated with paresthesia of the tongue. Computed tomographic examination of the parotid demonstrated a left superficial lobe mass with a rim of enhancement and low attenuation center. Fine needle aspiration yielded necrotic debris and atypical squamous elements that were thought to be compatible with carcinoma. A superficial parotidectomy with intraoperative frozen section revealed a pleomorphic adenoma with extensive central necrosis. To our knowledge, this represents the first reported case of an infarcted pleomorphic adenoma and illustrates the potential for misinterpretation of these cytologic and radiologic findings as indicative of malignancy.
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PMID:Spontaneous infarction of a parotid gland pleomorphic adenoma. Report of a case with cytologic and radiographic overlap with a primary salivary gland malignancy. 131 31

An 81-year-old man had left labial paresthesia and a palpable mass adjacent to the left mental foramen 6 months after apparent adequate excision of a small (1.5 cm) primary squamous cell carcinoma of the left portion of the lower lip. Biopsy and clinical evaluation revealed recurrent squamous cell carcinoma. Subsequent left hemimandibulectomy confirmed perineural extension of tumor along the mandibular branch of the trigeminal nerve to the foramen ovale. Seven months later, the patient died of complications resulting from intracranial extension of tumor to the left cerebellopontine angle. This case illustrates the lethal potential of carcinoma of the lip due to contiguous perineural extension, even with a small primary tumor and absence of regional lymph node metastases.
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PMID:Carcinoma of the lower lip with perineural extension to the middle cranial fossa. 233 14

The toxic effects and tissue uptake of both cisplatin and oxaliplatin--[(1R, 2R)-1,2-cyclohexanediamine-N,N'] [oxalato(2-)-O,O']platinum--were previously shown to vary similarly according to dosing time in mice. A 4-hour infusion of cisplatin resulted in fewer side effects and allowed administration of higher doses at 16 hours than at 4 hours in patients with cancer. We hypothesized that the continuous venous infusion of oxaliplatin for 5 days would be less toxic and would deliver a higher dose to the patient if the drug were infused at a circadian rhythm-modulated rate (peak at 16 hr; schedule B) rather than at a constant rate (schedule A). We tested this hypothesis in a randomized phase I trial. We escalated the dose of oxaliplatin to the patient by 25 mg/m2 per course. Courses were repeated every 3 weeks. An external, multichannel, programmable-in-time pump was used for the infusions. Toxicity was assessable for 94 courses in 23 patients (12 patients with breast carcinoma, nine with hepatocellular carcinoma, and two with cholangiocarcinoma). The incidence of neutropenia of World Health Organization grades II-IV and the incidence of distal paresthesias were 10 or more times higher (P less than .05) with schedule A than with schedule B. In addition, vomiting was 55% higher (P = .15) with schedule A than with schedule B. Furthermore, with schedule B, the mean dose of oxaliplatin (P less than .001) and its maximum tolerated dose (P = .06) could be increased by 15% over those doses with schedule A. An objective response was achieved in two of the 12 patients with previously treated breast cancer. We recommend that the dose of oxaliplatin for phase II trials be 175 mg/m2, delivered according to the circadian rhythm-modulated rate.
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PMID:Phase I trial of 5-day continuous venous infusion of oxaliplatin at circadian rhythm-modulated rate compared with constant rate. 234 69

A survey of the Japanese literature revealed 28 well-documented cases of central carcinoma of the jaws. There was no sex predominance and the mandible was the site of involvement in 26 cases. The most common initial symptom was local swelling, which was followed in order of frequency by spontaneous pain, paraesthesia of the lower lip, discomfort, loosening of teeth and trismus. On clinical examination, local swelling which was often accompanied by variable symptoms was an almost constant finding. Radiographic appearance varied from unilocular to worm-eaten type radiolucencies which were often surrounded by indistinct margins on close examination. Radical surgery, combined with irradiation and/or chemotherapy was the principal treatment in most cases, but there were 4 cases in which the lesions were simply excised under a tentative diagnosis of cyst; local recurrence was noted in 5 cases. Regional lymph node metastasis and lung metastasis were observed in 8 and 2 cases, respectively. No definite conclusion was drawn with regard to the prognosis because of the short follow-up period. Histologically, epidermoid carcinoma was most frequently seen, but odontogenic cyst was confirmed to be the site of origin in 3 cases only.
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PMID:Central carcinoma of the jaw. A survey of 28 cases in the Japanese literature. 265 24

Exaggerated acute and late effects were observed in three of four women with pre-existing collagen vascular disease (CVD) within 2 years after definitive megavoltage radiation therapy for breast carcinoma. Five women with breast carcinoma, who developed CVD 3 months to 10 years after radiation therapy, had no complications. An abnormally severe reaction was observed during treatment of one patient with discoid lupus. The patient developed moist desquamation that persisted for a month, requiring early termination of treatment. One year after treatment, the patient developed paresthesias in the ipsilateral arm. A planned reduction of the prescribed dose in a second patient with progressive systemic sclerosis did not prevent intense erythema at the end of treatment, followed 14 months later by chest wall necrosis, which eventually required multiple surgeries including chest wall resections. The third patient, who had systemic lupus erythematosis, developed necrosis 2 years after treatment, which progressed over 12 years to osteoradionecrosis of the clavicle, sternum and rib cage. Multiple surgeries to repair the defect were complicated by flap necrosis and pleurocutaneous fistulas. The fourth patient died 6 months after radiotherapy without apparent sequelae. None of the patients had evidence of recurrent carcinoma. A history of collagen vascular disease appears to be a contraindication to breast conservation or for elective irradiation for breast cancer.
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PMID:Consequences of breast irradiation in patients with pre-existing collagen vascular diseases. 277 73

Clinical and pathological analysis of 66 cases of fibromatoses are presented. The age range in our series was 1 to 72 years. Superficial fibromatoses occurred predominantly in older patients with a peak incidence in the fifties while deep fibromatoses occurred predominantly in younger patients with a peak incidence in the twenties. Male to female ratio was 1.4 to 1. The abdominal fibromatosis occurred in female while our palmar fibromatosis occurred in male. There were 17 cases (26%) of multiple fibromatoses which occurred most frequently on both palms and had a tendency to symmetric distribution. The latent period between the two fibromatoses in a patient ranged from 1 year to 36 years. Clinical presentations included a palpable nodule or mass; flexure contracture of finger; penile hypertrophy, contracture, or discomfort on erection; and soreness, tenderness, or paresthesia over the tumor. Hydronephrosis may be complicated by intraabdominal fibromatosis. Size of the tumors ranged from 0.5 cm. To 30.0 cm. Three cases were associated with diabetes mellitus, 2 with alcoholics, 1 with liver cirrhosis, 2 with pulmonary tuberculosis, and 3 with hepatocellular carcinoma, cholangiocarcinoma, and mammary papillary carcinoma, respectively. Nine cases (14%) were associated with variable types of trauma, including being hurt by a stick, intramuscular injection in the gluteal region, tying penile shaft with a plastic band, breast massage and hot applying, and operation on abdomen. The superficial fibromatoses seldom recurred after excisional biopsy or fasciectomy while the deep fibromatoses often recurred. The recurrent rate of the deep fibromatoses was 21%. Malignant transformation or spontaneous regression was not found.
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PMID:[The fibromatoses. A clinicopathological study of 66 cases]. 281 66

Fifteen patients with chronic sensory ataxia caused by a large-fiber sensory neuropathy were studied and followed up for a period of 17.4 years (range, 4 to 41). When first seen, they had distal paresthesias and sensory ataxia of slow onset and progression, areflexia, normal strength, and a profound loss of proprioceptive and kinesthetic sensation extending up to the most proximal joints. Needle electromyogram and motor-nerve conduction velocity findings were normal in most of the patients and sensory potentials were absent in all. Nerve biopsy showed severe loss of the large myelinated fibers. Nine patients had a serum monoclonal or polyclonal gammopathy (3 with IgM kappa, 1 with IgA kappa, and 5 with a polyclonal increase of IgG, IgA, or IgM), and 8 had elevated cerebrospinal fluid gamma globulin levels in spite of low normal total cerebrospinal fluid protein levels. No circulating antibodies to ganglionic neurons were found. Therapy with immunosuppressants or plasmapheresis was unsuccessful. All patients are disabled and their conditions have continued to worsen without signs of malignancy or systemic illness during a mean follow-up period of 17.4 years. Chronic idiopathic ataxic neuropathy is a proprioceptive neuropathy, clinically indistinguishable from the one associated with carcinoma or pyridoxine abuse due to involvement of the dorsal root ganglia, and could represent a distinct form of an indolent, slowly progressive sensory neuronopathy (ganglionopathy). Although immunopathological mechanisms may play a role, especially in patients with an associated paraproteinemia, the resistance of such patients to therapy, the progressive course, and the resemblance of this disorder to other toxic neuronopathies associated with pyridoxine abuse or doxorubicin administration suggest a possible toxic etiopathogenesis.
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PMID:Chronic idiopathic ataxic neuropathy. 301 95

The cases of three patients with spinal cord compression who presented with acute urinary retention are discussed. Two patients had previously diagnosed carcinoma; in one, acute urinary retention was the first sign of metastatic renal cell carcinoma. Two patients had a history compatible with prostatic hypertrophy. All had either paresthesias or sensory or motor deficits on initial presentation. All three patients were left with permanent hypotonic bladders. Two patients had permanent lower extremity paresis as well.
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PMID:Acute urinary retention as a presenting sign of spinal cord compression. 375 60


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