Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The objective is to evaluate and compare data on a cohort of terminal head and neck cancer (HNC) patients from both home and hospital-based hospice programs and to define the particular problems and needs of those patients. The setting was a tertiary academic referral centre in Tel Hashomer, Israel. We carried out a retrospective survey of patient charts based on hospice databases and death certificates of the hospital tumor registry. Charts of 102 HNC patients admitted to the hospice between 1988 and 1994 and 24 charts of HNC patients cared for by the home hospice program between 1990 and 1994 were studied. Pain, airway problems, and dysphagia were the common problems reported. A comparison of the two programs showed home hospice patients to be younger and with lower pain levels, less weight loss, and less oral candidiasis. There were fewer oral cavity tumor patients in the home hospice group. The incidence of distant metastases was in 50% range in both groups. Judging by chart entries relating to pain, airway care, and food intake, treatment protocols were effective in both programs in the alleviation of pain and other symptoms. Both programs appeared to provide adequate care for terminal HNC patients. The main difference in care between the two groups stemmed from the decisions of referring physicians and not from a predetermined level of care. The incidence of distant metastases was higher than that reported in earlier clinical series.
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PMID:Home and inpatient hospice care of terminal head and neck cancer patients. 910 52

A moderately differentiated neuroendocrine carcinoma or atypical carcinoid of the larynx occurred in a 68-year-old woman who developed rapidly progressive dysphagia, hoarseness and a neck mass. Immunohistochemical and electron microscopic studies verified the nature of this tumor. Local invasion and distant metastases are common. It is suggested that cigarette smoking could increase the risk of developing this neoplasm.
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PMID:Moderately differentiated neuroendocrine carcinoma (atypical carcinoid) of the larynx. 924 15

A 68-year-old woman with a history of breast and colon cancer at the ages of 48 and 65 years, respectively, who presented with dysphagia is described. An upper gastrointestinal series and endoscopic examination revealed a circumferential stricture without ulceration in the middle-third area of the esophagus. Computed tomography demonstrated a submucosal tumor in the esophageal wall. A biopsy specimen obtained from the mucosa overlying the tumor revealed poorly differentiated adenocarcinoma, suggesting metastasis from the previous breast cancer. Subtotal esophagectomy with reconstruction was performed. Macroscopically, a submucosal tumor measuring 2.0 x 1.7 cm was observed in the resected esophagus. Microscopic examination revealed poorly differentiated adenocarcinoma, which was quite similar histologically to the breast cancer resected 15 years previously. Enzyme immunoassay and immunohistochemical analyses of the resected tumor revealed positivity for both estrogen and progesterone receptor, confirming the diagnosis of a metastatic cancer from the previous breast tumor.
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PMID:Solitary esophageal metastasis of breast cancer with 15 years' latency: a case report and review of the literature. 931 Oct 12

A 60-year-old man noticed rapid enlargement of a long-standing thyroid goitre, with dysphagia and difficulty in breathing. Thyrotoxicosis was diagnosed. Chest X-ray revealed multiple pulmonary metastases. He underwent near-total thyroidectomy. The histopathology revealed an undifferentiated thyroid carcinoma with some areas of papillary carcinoma and its follicular variant. Postoperative 131I total body scan showed residual thyroid tissue in the neck and one functioning metastasis in the right rib, posteriorly. The patient's condition deteriorated rapidly and he died from pneumonia. The autopsy showed widespread metastases of undifferentiated thyroid carcinoma. Only the right rib contained the follicular variant of papillary carcinoma.
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PMID:Primary thyroid carcinoma and thyrotoxicosis. 953 90

Oat cell carcinoma is rarely diagnosed in the head and neck and can be primary or secondary. Primary tumors arise from amine precursor uptake and decarboxylation cells which are found throughout the head and neck. Secondary deposits metastasize most commonly from the lungs. We report a 64-year-old woman with a known pancreatic oat cell carcinoma who came to the ENT Department with dysphagia. On examination, a lesion was seen at the base of the tongue and was histologically an oat cell carcinoma. No treatment was administered and the patient died one month after discharge. This report highlights the difficulty in determining the primary site when a rare tumor metastasizes to the head and neck and no autopsy findings are obtained. To our knowledge, oat cell carcinoma of the tongue has not been previously reported.
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PMID:Oat cell carcinoma of the tongue from an unknown primary. 955 13

Primary malignant melanoma of the esophagus is extremely rare. Less than 200 cases have been published worldwide up to now. We report a case of a 65-years old male suffering from dysphagia for four months. The endoscopy showed a polypoidal tumor of black colour in the distal part of the esophagus. The histological diagnosis of the initial biopsy specimen was melanoma. Partial esophagectomy and lymph node sampling were performed. The resected specimen showed a polypoid tumor with black pigmentation of 8 x 5 x 3 centimeter. Histopathology revealed a primary malignant melanoma of the esophagus stage pT2 pN1 M0 and grading three. The patient died 8 months after resection from general metastatic disease. Age, sex, symptoms, duration of symptoms and time of survival are similar as described in former cases.
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PMID:[Primary malignant melanoma of the esophagus]. 958 89

Leiomyosarcoma of the oesophagus is a very unusual tumour; only 53 cases have been reported in the English-language literature. A case is reported here of a patient with a giant leiomyosarcoma, without any symptoms of dysphagia. The diagnosis was made incidentally during CT examination of the chest for detection of possible pulmonary metastases from a coexisting carcinoma of the bladder. This was confirmed by a barium swallow, oesophagoscopy and tissue diagnosis. The literature pertaining to this most uncommon tumour is reviewed.
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PMID:Incidental computed tomography diagnosis of a giant oesophageal leiomyosarcoma. 959 38

Metastatic malignant tumors of the thyroid are rarely encountered clinically. Most arise from primary sites in the lung, breast, kidney or gastrointestinal tract. Their clinical presentation may mimic a primary thyroid tumor and include signs and symptoms such as enlargement of the neck, hoarseness and dysphagia. Without a history of carcinoma in other organs, management as for primary thyroid tumor is often undertaken and misdiagnosis is common. This report concerns a 63-year-old female patient with a rapidly progressive enlargement of the neck. She had had a primary leiomyosarcoma lesion in her left leg that had been well controlled after wide excision. Bilateral pulmonary metastases were noted two years later without local recurrence. She receive wedge lung resections several times. To relieve progressive shortness of breath, debulking surgery of the thyroid was performed and metastatic leiomyosarcoma was proved. The related clinical data of this rare metastatic leiomyosarcoma of the thyroid is presented and the literature is reviewed.
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PMID:Metastatic leiomyosarcoma of the thyroid: a case report. 968 12

Oropharyngeal dysphagia in adults is secondary to either a structural lesion or neuromuscular disorder of the upper esophageal sphincter. In cricopharyngeal achalasia (incomplete relaxation of the upper esophageal sphincter), the etiology is usually either related to neck surgery or other neuromuscular disorders. We report on a rare case of neuromuscular oropharyngeal dysphagia secondary to bone metastases to the base of the skull. The patient is an 81-year old man with prostate cancer with metastases to the sacrum. A gastroscopy was attempted to discern the etiology of his dysphagia, but the endoscope could not be advanced. A barium swollow showed cricopharyngeal achalasia, and an magnetic resonance image of the brain demonstrated bone destruction to the floor of the left posterior fossa in the region of the jugular foramen and foramen magnum. The bone destruction caused disruption of the glosso-pharyngeal and vagus nerves. Selective radiotherapy resulted in rapid improvement in his symptoms. The primary treatment of cricopharyngeal achalasia is to correct the underlying process, if possible. This case illustrates an unusual presentation of secondary cricopharyngeal achalasia caused by cranial nerve involvement secondary to bone metastases.
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PMID:Neuromuscular oropharyngeal dysphagia secondary to bone metastases. 975 2

A 76-year-old man insidiously developed diffuse neurological symptoms: cognitive decline, dysphagia, dysphasia and mental disturbance. Computed tomography of the cranium revealed widespread bilateral brain edema and symmetrical bilateral sphenoid wing hyperostosis. Adjacent to the hyperostosis that resembled skull base meningiomas, two separate parenchymatous temporal lobe lesions enhancing with contrast medium were observed. The patient had earlier been diagnosed to have prostatic carcinoma. Dexamethasone therapy resulted in discontinuation of the neurological symptoms. The diagnosis of metastasized adenocarcinoma of the prostate was confirmed histologically on autopsy after a sudden death from pneumonia. Intracranial metastases of prostate cancer may have a predilection site at the sphenoid wing, and can mimic a skull base meningioma. Intracranial spread of prostatic adenocarcinoma should be considered in elderly men as a treatable cause of gradual neurological deterioration, especially if cranial malignancy or hyperostosis is found.
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PMID:Bilateral sphenoid wing metastases of prostate cancer presenting with extensive brain edema. 1021 Sep 20


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