Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 50-year-old Japanese female with choriocarcinoma showed three unusual features: the primary tumor developed in the vagina ectopically without uterine lesion; the first symptoms of atypical vaginal bleeding and coughing occurred 23 years after the last pregnancy; and the tumor appeared during postmenopause. The possible mechanisms for the ectopic location and latency are discussed.
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PMID:Latent vaginal choriocarcinoma in a postmenopausal woman. 103 57

Choriocarcinoma with a primary site in the chest is rarely found. Characteristically, it is seen in young men presenting with cough, gynecomastia and chest pain. The disease is invariably fatal. The presently accepted therapy (triple therapy), consisting of methotrexate, actinomycin D and chlorambucil, has been unsuccessful to date.
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PMID:Primary mediastinal choriocarcinoma in a man. 108 17

From 1949 to 1988, 32 cases of hemothorax were seen in our hospital. The incidence rate of hemothorax among the cases of choriocarcinoma and invasive mole in the whole series were 2.6% and 1.4% respectively. The most frequent symptoms were chest pain, cough, dyspnea, and hemoptysis. Before 1965, when 6-MP was the only agent used, 7 of the 16 patients with hemothorax died directly due to severe intrathoracic hemorrhage, from 1966 to 1988, when intravenous infusion of 5-FU and intrathoracic injection of 5-FU were used, only 4 of the 16 cases died, there was no death directly related to hemothorax. About 75% were followed up for more than 10 years, the longest duration of follow up being more than 28 years in 6 cases. Repeated examinations with serum hCG determination and chest film revealed no evidence of recurrence, nor pleural adhesion and thickening or pulmonocardiac diseases.
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PMID:[Diagnosis and treatment of hemothorax in malignant trophoblastic tumors]. 132 70

A review of 56 cases of primary malignant germ cell tumors of the mediastinum revealed that, as with benign teratomas, the tumors occurred in young adults (mean age 29 years) but that the sex distribution differed (86% male and 14% female). A single germ cell element was found in 37 (66%) of the tumors, and various combinations were present in the remaining 19 (34%). The tumors were classified among five recognized types of germ cell tissues. There were 24 seminomas (22 pure and two with mature teratomas), 17 embryonal carcinomas (nine pure and eight with mixtures), five teratomas, seven choriocarcinomas (three pure and four with mixtures), and three pure yolk sac tumors. Most (86%) of the patients were symptomatic at the initial examination, with chest pain, cough, and loss of weight being the most frequent presenting symptoms. The standard posteroanterior and lateral roentgenograms were the most helpful diagnostic tool, showing evidence of an anterior mediastinal mass in 53 patients. The diagnosis was established by surgical exploration of the mediastinum or by biopsy of a lymph node in 55 patients. Of the 55, 24 (43.6%) had complete resection of the tumor and 31 (56.4%) had incomplete resection or biopsy alone. The overall prognosis for mediastinal germ cell tumors is poor, partly because the tumors are far advanced at the time of diagnosis but also because some of the tumors that contain embryonal cell carcinoma, choriocarcinoma, and yolk sac elements are very aggressive. Factors that were prognostic in patients with seminoma--such as age, presence of the superior vena caval syndrome, lymphadenopathy, evidence of hilar disease on the chest roentgenogram, and resectability--were not predictive in patients with other types of malignant germ cell tumors. Although aggressive combination chemotherapy may represent a significant treatment modality for nonseminomatous mediastinal tumors, the present study spanned many years in which no chemotherapy was available. Patients in the later years of the study received combination chemotherapy with various treatment regimens. No conclusions concerning specific chemotherapy, therefore, can be derived from this study.
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PMID:Malignant germ cell tumors of the mediastinum. 298 74

A 32-year-old woman who complained of cough and hemoptysis was found to have a metastatic trophoblastic tumor in her lungs and in a supraclavicular lymph node. A regressed primary teratoma of the ovary was considered the most likely origin of the tumor. Sputum cytology showed malignant cells, many of which were in elongated fiberlike forms and some of which had orange-staining cytoplasm. These cytologic appearances of choriocarcinoma are described and compared with the brief descriptions available in the literature. The possibility of misdiagnosis as squamous carcinoma is emphasized. The correct diagnosis is of particular importance because choriocarcinoma of gestational origin, which is similar cytologically to that of teratomatous origin, responds well to chemotherapy.
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PMID:Sputum cytology of metastatic choriocarcinoma: a case report. 693 63

Primary choriocarcinoma of the anterior mediastinum is by far the rarest and most controversial form of extragonadal germ cell tumor. A clinicopathologic study of eight primary mediastinal neoplasms bearing the histopathologic and immunohistochemical features of choriocarcinoma is presented. The patients were all men between the ages of 21 and 63 years (mean, 42 years). Clinical symptoms included shortness of breath, chest pain, cough, and superior vena cava syndrome; one patient also had gynecomastia. All patients presented with large anterior mediastinal masses on chest radiographs that measured an average of 10 cm in greatest diameter. Grossly, the tumors were described as large, soft, extensively hemorrhagic, and with foci of necrosis. Histologically, they were characterized by a dual cell population composed of cytotrophoblastic cells with uniform, round nuclei, clear cytoplasm, and prominent nucleoli admixed with large, multinucleated syncytiotrophoblastic cells with bizarre nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm. Immunohistochemically, the tumors were notable for strong keratin and beta-human chorionic gonadotropin (HCG) positivity. Seven patients presented at the time of diagnosis with thoracic and extrathoracic (liver, adrenal, kidney, and spleen) metastases. In one case, the tumor was entirely confined to the mediastinum. All patients died over a period of 1 to 2 months. Complete autopsies were performed in all cases; none of the patients showed evidence of a testicular tumor or scar after thorough examination of the testes on serial sectioning. The present cases demonstrate the widespread distribution of germ cells in the human body and lend further support to the existence of primary extragonadal choriocarcinoma arising in the thymic region.
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PMID:Primary mediastinal choriocarcinomas: a clinicopathologic and immunohistochemical study of eight cases. 929 76

A 19-year-old Japanese male developed a cough, chest pain, and high fever. CT of the chest revealed a bulky mediastinal tumor (13 x 10 x 8 cm) and bilateral multiple pulmonary nodules. CT of the abdomen and pelvis was normal. Laboratory evaluation showed a beta human chorionic gonadotropin (beta HCG) level of 985 ng/mL. Testicular ultrasonography demonstrated multiple, bilateral punctate echoes characteristic of testicular microlithiasis (TM). No primary testicular tumor was detected. Needle biopsies of the testes did not reveal cancer and calcification. Transthoracic needle biopsy of the mediastinal tumor showed choriocarcinoma. No correlation is known between TM and choriocarcinoma without testicular cancer, but the incidence of TM in this patient may reflect his high human chorionic gonadotropin level.
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PMID:Testicular microlithiasis with mediastinal choriocarcinoma: a case report. 962 68

A 25-year-old man who suffered from cough, sputum, and swelling of left scrotal contents was admitted to our hospital. We found testicular choriocarcinoma with multiple lung, liver, and brain metastases. The patient received 5 courses of VIP therapy (cisplatin, etoposide, ifosfamide) and 1 course of high-dose chemotherapy (carboplatin, etoposide, cyclophospamide) with peripheral blood stem cell transplantation. One year later, the patient underwent surgery for resection of lung metastasis after 1 course of chemotherapy (cisplatin, etoposide). Pathological diagnosis showed a remnant of choriocarcinoma. Three years and three months after surgery, no recurrence of the choriocarcinoma has been found.
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PMID:[A difficult case of advanced testicular choriocarcinoma effectively treated by chemotherapy and resection of lung metastasis]. 1499 65

A 34-year-old woman visited our hospital complaining of dry cough. Chest radiography and computed tomography showed bilateral multiple infiltrative shadows over the lung field. After an initial diagnosis of pneumonia, antibiotics were administered, but the therapy failed to improve the symptoms and abnormalities observed on the chest radiograph. The patient was then admitted to our hospital. The bronchoalveolar lavage fluid (BALF) was slightly bloody, but we were not able to make any specific findings in BALF. In order to confirm the pathological diagnosis, video-assisted thoracoscopic lung biopsy was performed aiming at the right middle and lower lobes. There were bleeding pulmonary infarctions in a biopsy specimen from the right middle lobe. Atypical cells positive for human chorionic gonadotropin (hCG) proliferated in the pulmonary arteries, and so a diagnosis of pulmonary embolic metastasis of choriocarcinoma was made. After the diagnosis, it became clear that urine and serum hCG values were very high. The patient has since received systemic chemotherapy in the gynecology unit at our hospital. Pulmonary embolic metastasis of choriocarcinoma diagnosed by video-assisted thoracoscopic lung biopsy has never been reported in the literature. However, early hCG measurement may have detected this syndrome in the earlier stages, and pulmonary metastasis of choriocarcinoma should be considered in the differential diagnosis of women with past pregnancy presenting with intractable multiple pulmonary shadows.
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PMID:[A case of pulmonary embolic metastasis of choriocarcinoma presenting with multiple pulmonary infiltrative shadows]. 1535 72

A 30-year-old man presented with cough and bloody sputum. He brought a chest radiogram showing abnormal findings. His chest computed tomography revealed a large mediastinal mass and multiple nodular shadows in both lungs. The serum beta-HCG level was remarkably elevated, and physical examination revealed bilateral gynecomastia and right supraclavicular lymph node swelling. His lymph node was biopsied and choriocarcinoma was diagnosed. After 3 cycles of BEP therapy (cisplatin, etoposide, bleomycin), the tumors regressed and the serum beta-HCG level decreased. Although there were residual tumors and serum beta-HCG was mildly elevated, he refused additional therapy. The choriocarcinoma progessed rapidly again and he died seven months after his first visit. Primary mediastinal germ cell tumors are rare, and in particular the pure type of choriocarcinoma arising in the mediastinum is even rarer. Patients with mediastinal choriocarcinoma are mostly young men. The prognosis of primary mediastinal choriocarcinoma is still very poor despite the introduction of combination chemotheraphy including cisplatin. We report a case of primary mediastinum pure choriocarcinoma. Chemotherapy was effective for the patient, but he died because of recurrence after refusal of future treatment. Establishment of more effective treatment is necessary.
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PMID:[A case of primary mediastinal choriocarcinoma]. 1650 67


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