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)

Between 1984 and 1997 year 4985 patients underwent surgical treatment due to various thyroid gland diseases, among them were 28 (0.6%) patients with intrathoracic goitre, but only in one case (0.002%) the signs of superior vena cava syndrome (SVCS) were observed: oedema and lividity of the face, enlargement of jugular veins and superior limbs' veins. In addition the patient manifested subsequently growing dyspnoea, dysphagia and hoarseness. In diagnose essential were X-ray examination of the chest (widening of mediastinal shadow), X-ray examination of the trachea (dislocation and compression of the trachea), X-ray of esophagus with contrast (compression from the outside), ultrasonography of thyroid gland. Intraoperatively, after it was confirmed that the SVCS was caused by compression of the intrathoracic right lobe of thyroid gland, the oblong sternotomy was performed to provide the proper surgical access for subtotal thyroidectomy. The weight of resected tissues of thyroid gland was 1036 g. In histopathological examination the diagnosis of multinodular toxic goitre was confirmed.
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PMID:[Intrathoracic goiter as a cause of superior vena cava syndrome]. 1021 81

A 71-year-old woman, who presented tracheobronchial obstruction caused by a thoracic aortic aneurysm, was admitted to our institution. Although she had multiple cerebral infarctions, old myocardial infarction, bilateral iliofemoral atherosclerotic lesions with abdominal aortic aneurysm, and superior vena cava syndrome, aneurysmectomy was undertaken in order to rescue her from respiratory insufficiency. The operation successfully relieved her of exertional dyspnea and dysphagia.
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PMID:Respiratory insufficiency caused by an aneurysm with multiple vascular lesions. 1067 Aug

A 68-year-old woman had felt a chest and back pain for 3 months. Gradually her symptom became aggravated, and she felt severe dyspnea in supine position and dysphagia combined with superior vena cava syndrome. A huge posterior mediastinal tumor was revealed and her esophagus was severely narrowed on the chest MRI. Therefore, emergency tumor resection was scheduled under general anesthesia. Anesthesia was induced by midazolam (2 mg) with the patient in the right lateral position. After gas exchange and oxygenation were comfirmed by pulse oximetry reading and clinical signs, she was slowly turned to supine position. But, suddenly, ST-segment depression and low amplitude developed in electrocardiogram and systolic blood pressure was depressed to below 60 mmHg. Therefore, she was rapidly retuned to right lateral position, and ST-segment and systolic blood pressure recoverd. On the next time, although she was slowly turned to the right semi-lateral position, there was almost no circulatory failure. A bronchial tube was intubated in her left bronchia under bronchoscope. We should remember that the preparation of percutaneous cardiopulmonary support (PCPS) should be considered as a means of protection against cardiovascular collapse or airway obstruction perioperatively.
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PMID:[A patient with a huge posterior mediastinal tumor and ST-segment depression in electrocardiogram]. 1544 83

Retrosternal goiters are commonly situated in the anterior mediastinum, but according to the literature, 10-15% are located in the posterior mediastinum. The authors report two cases of enormous goiter in the posterior mediastinum. Case 1 was a 60-year-old man. His mass measured 12 x 9 x 8 cm and was combined with trachea compression and superior vena cava syndrome. Case 2 was a 59-year-old woman. Her mass measured 9 x 6 x 6 cm and she was admitted with the complaint of dysphagia. Both patients were discharged from hospital after successful operations. They reported normal activities in the follow-up.
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PMID:Enormous goiter in posterior mediastinum: report of 2 cases and literature review. 1936 82

We herein describe a patient we encountered in whom mediastinal lymph node metastasis of lung cancer with an unknown primary lesion was complicated by both an endocrine abnormality and acanthosis nigricans. A 66-year-old male visited a local hospital and was diagnosed as having acanthosis nigricans. The patient was referred to our hospital for further examination. Computed tomography scans of the chest and the abdomen showed no adverse findings except for an enlargement of the mediastinal lymph node. No malignant lesions were detected in examinations of the upper gastrointestinal tract. Based on the above findings, the lesion was thus considered to possibly be mediastinal lymph node metastasis of an unknown primary tumor or malignant lymphoma. A thoracoscopic biopsy of the mediastinal lymph node was performed. The patient was diagnosed to have mediastinal lymph node metastasis of lung cancer with an unknown primary lesion and endocrine abnormality resulting from paraneoplastic syndrome. Palliative radiation therapy was initiated to prevent superior vena cava syndrome and esophageal passage failure or dysphagia. The cutaneous lesions markedly improved thereafter. The serum levels of adrenocorticotropic hormone decreased.
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PMID:Mediastinal lymph node metastasis of lung cancer with an unknown primary lesion having concurrent endocrine abnormality and acanthosis nigricans: report of a case. 2008 50

Transitional cell carcinoma of the urinary bladder is a malignancy that metastasizes frequently to lymph nodes including the mediastinal lymph nodes. This occurrence may produce symptoms due to compression of adjacent structures such as the superior vena cava syndrome or dysphagia from esophageal compression. We report the case of a 59-year-old man with metastatic transitional cell carcinoma for whom mediastinal lymphadenopathy led to pulmonary artery compression and a rapidly fatal outcome. This rare occurrence has to be distinguished from pulmonary embolism, a much more frequent event in cancer patients, in order that proper and prompt treatment be initiated.
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PMID:Rapid fatal outcome from pulmonary arteries compression in transitional cell carcinoma. 2011 32

The intrathoracic (or substernal) goiter is more often benign; but it can be malignant in 2-22% of patients. There is history of prior thyroid surgery in 10% to more than 30% of patients. Intrathoracic goiters cause adjacent structure compression more frequently than the cervical goiters, due to the limited space of the thoracic cage. Compression of trachea, oesophagus, vascular and neural structures may cause dyspnoea, dysphagia, superior vena cava syndrome, subclavian vein thrombosis, hoarseness, and Horner's syndrome. There is usually progressive deterioration, but acute exacerbation may occur. The presence of a thoracic goiter (>50% of the mass below the thoracic inlet) is per se an indication for resection. Tracheal compression by (cervical or thoracic) goiter is also an indication for resection; early tracheal decompression is recommended particularly in symptomatic patients. In severe respiratory distress, intubation and semi-urgent operation may be required. With early intervention, most intrathoracic goiters can be removed through a cervical approach, while tracheomalacia is avoided. We hereby present successful and uncomplicated total thyroidectomy, through a median sternotomy, of a benign, gigantic, bilateral, retrovascular, posterior mediastinal, intrathoracic goiter, encircling the trachea, and causing severe respiratory distress in a 63 year old man with history of previous subtotal thyroidectomy.
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PMID:Resection of a giant bilateral retrovascular intrathoracic goiter causing severe upper airway obstruction, 2 years after subtotal thyroidectomy: a case report and review of the literature. 2330 40

A 61-year-old man presented with dysphagia, weight loss and shortness of breath. On examination, he had reduced lung sounds on the right, and obvious neck vein distention. Chest X-ray raised a suspicion of lung tumor with possible superior vena cava syndrome. Subsequent CT scan of chest confirmed the presence of markedly dilated and tortuous esophagus (sigmoid megaesophagus) extending to the right hemithorax and pressing on the trachea. The patient was referred for surgery.
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PMID:Sigmoid megaesophagus with thoracic pseudotumor appearance. 3268 31


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