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

The clinical and pathologic characteristics of five patients with esophageal sarcomas are presented, including the only recorded esophageal Triton tumor (malignant schwannoma), the third recorded synovial sarcoma, two patients with carcinosarcoma, and one with leiomyosarcoma. All five patients were males who presented with dysphagia. Three tumors were in the cervical esophagus, and the remaining two were in the distal esophagus. On endoscopic examination, three of the tumors were noted to be polypoid, while the other two were sessile. Two patients presented with disseminated disease, and a third was locally unresectable. These three patients were treated with palliative intent. The remaining two patients underwent surgical excision and postoperative radiation therapy, and are alive and well 6 and 7 years following treatment. This experience suggests that combined modality therapy employing postoperative radiation may be effective in managing these rare lesions.
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PMID:Esophageal sarcomas. 165 95

The case of a 62-year-old man with benign schwannoma associated with a giant polyp of the esophagus is presented. His initial symptom was dysphagia. The polyp was removed through cervical esophagotomy. He had no recurrence of symptoms 5 years after this procedure. Pathologic examination showed a rare histology.
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PMID:Benign schwannoma of the esophagus presenting as a giant fibrovascular polyp. 173 84

A rare case of vagal schwannoma (neurilemoma) with involvement of the distal esophagus is presented. Chronic progressive dysphagia was the only complaint related to the schwannoma. Barium swallow showed narrowing of the distal esophagus. The tumor was embedded in the wall of the esophagus. After biopsy and diagnosis of benign schwannoma, it was dissected from the esophageal muscle and mucosa. Diagnosis of benign schwannoma should be made before excision of the lesion to avoid an unnecessary esophagectomy.
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PMID:Vagal schwannoma involving esophagus. 175 91

The authors report a rare case of a huge jugular foramen neurinoma extending to pharyngeal region in a 64 year-old woman who visited an otolaryngologist with complaints of dysphagia, hoarseness and headache in 1984. At that time a submucosal lump was noted in her left pharyngeal region. Biopsy of the tumor proved it to be neurinoma. A CT scan disclosed a dumbell shaped jugular foramen neurinoma and noncommunicating hydrocephalus. Because her symptoms slowly progressed and cerebellar signs as well as signs of increased intracranial pressure was noted, she was referred to our hospital in 1986. She had shown typical sings of left Vernet syndrome, VIIth, VIIIth cranial nerve impairment as well as cerebellar, long tract and increased ICP signs. A subtotal removal was performed from the extracranial and posterior fossa in one stage. The tumor seemed to originate from the Xth cranial nerve. The histological diagnosis of neurinoma was confirmed. Postoperatively, although her dysphagia increased for several weeks, a tracheostomy was not necessary. She was discharged 2 months later and returned to her usual occupation as a house wife. Slight dysphagia and hoarseness were her only chronic symptoms. So far, 88 cases of jugular foramen neurinoma have been reported, 15 of them including our case from Japan. Our case is probably the largest of these reported tumors. Tumors in jugular foramen often masquerade as an acoustic neurinoma or other tumor. However, recently this can usually be diagnosed preoperatively with a careful neurological examination and by means of neuroradiological investigations such as jugular venography, CT scan and MRI.
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PMID:[Huge jugular foramen neurinoma extending to the pharyngeal region: a case report]. 341 64

The authors report a case of cervical schwannoma with an atypical clinical expression, site and imaging features. The anteromedian lesion lying in the prevertebral and retropharyngeal spaces accounts for its clinical expression in the form of dysphagia. The target appearance on computed tomography and on the T2-weighted MRI sequence was suggestive of a neurofibroma and was due to deposition of fibrin and haemorrhagic exudates in the center of the lesion. The presence of a prevertebral ansa cervicalis in front of the long muscles of the neck, between the longus capitis and longus colli muscles, accounts for the vertical, elongated appearance of this tumour involving the prevertebral space.
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PMID:[An unusual cause of dysphagia: cervical schwannoma of the prevertebral space. Radioclinical correlations]. 774 64

Two cases of benign schwannoma of the esophagus are presented. The tumors were found in the thoracic esophagus of women of 56 and 64 years of age, respectively, who had complained of dysphagia and back pain. Tumorectomies were performed and the tumors were found to be located within the esophageal wall arising from the muscularis propria. The tumors were examined immunohistochemically and ultrastructurally. These tumors were identical in gross, histological and electron microscopic features. Grossly, the tumors showed yellowish-white cut surfaces without hemorrhage or necrosis. Microscopically, they were composed of spindle-shaped cells showing moderate variation in size and shape, and nuclear palisading. Lymphoid aggregates with germinal centers surrounded the tumors. Immunohistochemically, strong reactions for S-100 protein and neuron-specific enolase were observed in the cytoplasm of spindle cells, whereas reactions for muscle actin and desmin were negative. These findings, together with electron microscopic observations, supported the Schwann cell origin of these tumors.
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PMID:Benign schwannoma of the esophagus: report of two cases with immunohistochemical and ultrastructural studies. 805 13

A case of cervical glossopharyngeal schwannoma presenting with gagging dysphagia is presented. Treatment was by total excision of the schwannoma following which the patient made a good recovery. To our knowledge, this is the first report of gagging dysphagia associated with a glossopharyngeal schwannoma.
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PMID:Glossopharyngeal schwannoma presenting as gagging dysphagia. 818 55

Cervical vagus neurinoma with hypoglossal palsy is extremely rare and only one case has been reported so far in Japan. A 52-year-old female complained of dysarthria. She has hypoglossal palsy with left-deviated tongue and the left half of her tongue was markedly atrophic. Cervical mass was not palpable and she had no other complaint such as hoarseness or dysphagia. CT scan and MRI revealed a tumor at a caudal part of the left jugular foramen. A hypoglossal canal was intact. Cerebral angiography demonstrated arterio-venous dissociation but vascular formation or tumor stain was not revealed. The tumor was totally removed by transpetrosal approach. The vagus nerve became thicker above C2 level and changed into the yellowish tumor with clear margin. The hypoglossal nerve was compressed between the tumor and an occipital bone. The authors think this is why hypoglossal palsy appeared. Histologically, the tumor was neurinoma. Clinical symptoms, diagnosis, and treatment were discussed.
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PMID:[A case of cervical vagus neurinoma with hypoglossal palsy]. 836 53

A case of right trigeminal neurinoma extending from the cavernous sinus to the cerebellopontine angle in a 48-year-old male is reported. The patient first noticed right facial numbness in June 1993. Six months later, he experienced headaches with occasional nausea, diplopia, ataxic gait, tinnitus and dysphagia and was referred to our department on January 21, 1994. Neurological examination on admission showed multiple cranial nerve palsy from the 4th to 11th nerve on the right, and the cerebellar sign on the right. Initial CT and MRI revealed a large mass lesion extending from the right cavernous sinus to the right cerebellopontine angle. On February 16, 1994, radical resection of the tumor, except the lesion invading the cavernous sinus, was performed via a combined retroauricular and preauricular transpetrosal transtentorial approach. The histological diagnosis was neurinoma. The patient's postoperative course was uneventful and there was good clinical improvement, although the right facial numbness and mild diplopia persisted. On April 6, 1994, radiosurgery was performed with a maximum dose of 28 Gy and a marginal dose to 14 Gy to the remaining cavernous sinus lesion. Two weeks after radiosurgery, the patient achieved a complete return to his daily routine. Two-year follow-up CT and MRI showed a small residual les on in the right cavernous sinus alone. There was no evidence of tumor growth. No new neurological deficits had developed, and the patient's the double vision had resolved. Thus, the patient has been able to maintain a satisfactory level of activities of daily living. We wound like to emphasize the clinical value of the strategy used to treat this patient which combined microsurgery with subsequent radiosurgery.
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PMID:[Therapeutic effectiveness of combined microsurgery and radiosurgery in a patient with a huge trigeminal neurinoma]. 888 34

A 68-year-old female presented with rare brainstem schwannoma manifesting as right hemiparesis, diplopia, and dysphagia. Neuroimaging revealed a lesion in the pons and cerebral peduncle, which was supposed to be a highly malignant glioma. The mass was approached via a single-flap orbitozygomatic craniotomy through an anteromedial pericavernous approach. Intraoperative frozen-section specimens indicated glioma, but the tumor was distinct from the surrounding parenchyma, and could be removed successfully. A tumor capsule was found and also removed. Postoperative histological, immunohistochemical, and ultrastructural examinations confirmed the diagnosis of benign schwannoma. Most schwannomas, even in the brainstem, are benign and complete removal may be curative.
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PMID:Brainstem schwannoma--case report. 900 17


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