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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Meningiomas are common brain tumors which are generally benign, well circumscribed, and slow growing. In a minority of patients, complete surgical removal is not possible and regrowth of tumor tissue is a major clinical problem. Most meningiomas contain progesterone receptors and the antiprogestational drug mifepristone (RU 486) binds to these receptors. 10 patients were treated with 12 recurrent or primary inoperable meningiomas, all of whom had shown recent neuroradiological and/or ophthalmological evidence of tumor growth. They received 200 mg mifepristone daily for 12 months. Most patients initially had complaints of nausea, vomiting, and/or tiredness. In 4 patients, prednisone (7.5 mg/day) was given, after which these side effects subsided. CT scan analysis of tumor size showed a progression of growth of 5 meningiomas in 4 patients, stable disease in 3 with 3 tumors, and regression of 3 tumors in 3 patients. A decrease in the complaints of headache and an improved general well being was observed in 5 patients. 2 patients died during the treatment period from unrelated causes. Mifepristone treatment resulted in control of tumor growth (stable disease) in 6 of 10 patients who had shown recent evidence of tumor growth. In 3 of these 6 patients, consistent tumor shrinkage was seen.
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PMID:Mifepristone (RU 486) treatment of meningiomas. 161 17

The possibility that meningioma growth may be related to female sex hormone levels is suggested by several lines of evidence. Meningiomas are twice as common in women as in men, have been observed to wax and wane with pregnancy, and are positively associated with breast cancer. A physiological explanation for these phenomena is provided by the finding of steroid hormone receptors in meningiomas. However, unlike breast cancer, meningiomas are much more commonly positive for progesterone receptors than for estrogen receptors. The authors initiated a study on long-term oral therapy of unresectable meningiomas with the antiprogesterone mifepristone (RU486). Fourteen patients received mifepristone in daily doses of 200 mg for periods ranging from 2 to 31+ months (greater than or equal to 6 months in 12 patients). Five patients have shown signs of objective response (reduced tumor measurement on computerized tomography scan or magnetic resonance image, or improved visual field examination). Three have also experienced subjective improvement (improved extraocular muscle function or relief from headache). The side effects of long-term mifepristone therapy have been mild. Fatigue was noted in 11 of the 14 patients. Other side effects included hot flashes in five patients, gynecomastia in three, partial alopecia in two, and cessation of menses in two. Long-term therapy with mifepristone is a new therapeutic option that may have efficacy in cases of unresectable benign meningioma.
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PMID:Treatment of unresectable meningiomas with the antiprogesterone agent mifepristone. 203 44

A surgical case of prolactinoma associated with craniopharyngioma is reported. A 47-year-old man was admitted to some neurosurgical clinic on October 12, 1982, because of visual disturbance, general fatigue and impotence. Laboratory study revealed hyperprolactinemia (360 ng/ml) and slight enlargement of sella turcica indicated the pituitary adenoma. Transsphenoidal surgery was performed to remove the tumor on November 20, 1982. Histopathological examination revealed chromophobe adenoma, and prolactin was stained in the tumor cells by means of immunoperoxidase staining. Though the clinical symptoms had been improved after surgery, visual disturbance became worse about one month later. At that time empty sella syndrome was suspected and the second operation (interhemispheric approach) was performed on January 21, 1983. No pathological changes were observed at all. On July 13, 1983, he was transferred to our clinic, because his visual acuity was deteriorating. At this time we reviewed the previous CT scan and noticed a suprasellar mass. It was supposed that the lesion had been overlooked and was the cause of the visual disturbance. On August 1, 1983, a bifrontal craniotomy was performed and the suprasellar tumor was removed. Pathological examination of the tumor revealed craniopharyngioma. So it was supposed that pituitary adenoma and craniopharyngioma had been coexisting since onset. Except for cases with von Recklinghausen's disease, multiple primary intracranial tumors of different cell types are relatively rare. A review of literature revealed 94 cases until 1986. The most frequent combination of multiple tumors was meningioma and glioma. But we could not find any case of pituitary adenoma associated with craniopharyngioma in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of prolactinoma associated with craniopharyngioma]. 344 1

Epidemiological evidence, including the greater incidence of female patients, a positive association with pregnancy, and a positive association with breast cancer suggested a role for female sex hormones (and hormonal modulation) in regulating the growth of meningioma. The detection of hormone receptors on meningioma specimens provided a mechanism for this effect. However, unlike breast cancer, progesterone receptors (not oestrogen receptors) predominate in meningioma. Clinical trials with anti-oestrogens have shown little effect while trials with progesterone agonists have shown no effect or possible stimulation of meningioma growth. Three trials have now indicated an inhibitory activity of the antiprogestational agent mifepristone. In the largest of these trials, 28 patients received daily oral mifepristone for up to 62 months with a suggestion of response in eight patients. Long-term therapy has been well tolerated. Adverse events include fatigue, hot flushes, gynaecomastia/breast tenderness, skin rash, cessation of menses and decrease in libido. Increases in cortisol and thyroid-stimulating hormone are the most striking endocrine changes. A randomized double-blind placebo-controlled phase III trial is underway to confirm the activity of mifepristone in unresectable meningioma.
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PMID:Role of antiprogestational therapy for meningiomas. 796 66

The authors present the case of a patient treated in the Department of Infectious Diseases at CMUJ in Cracow. The patient's full clinical picture suggested the possibility of the development of neuroborreliosis and disguised the symptoms of a developing intracranial tumor. Neuroborreliosis was suspected due to epidemiologic history (a tick bite, erythema migrans), general symptoms (fatigue, hypersomnia, apathy, dysmnesia, concentration disorders) and neurological symptoms, seropositive tests for Borrelia burgdorferi in serum and cerebrospinal fluid (IgG), increased protein concentration in cerebrospinal fluid. Owing to the fact that the serologic criteria of neuroborreliosis were not fulfilled, and other symptoms (loss of consciousness) appeared, CT was done. The CT showed the presence of a tumor in the longitudinal fissure of the brain, which, after intraoperative and histopathological examination, was defined as meningioma.
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PMID:[The coexistence of an intracranial tumor and a positive epidemiologic history of Lyme borreliosis as the reason for diagnostic problems--case report]. 1069 87

We use the ultrasonic surgical system in the treatment of brain tumors such as meningioma, neurinoma, glioma, etc. SONOPET is a useful and safe ultrasonic surgical system for microsurgery. The outer diameter of the tip of ultrasonic surgical systems is usually 2.5 mm and the inner diameter 2.0 mm. However, the outer diameter of the SONOPET is 1.9 mm and the inner diameter 1.5 mm. Even in a deep site, because of the small diameter tip, the operation can be done easily. Further, the very thin outer diameter of the tip flue, 5 mm, makes it easy to operate in the deep site. The maximum amplitude of the distal end tip, which can be an important factor in tissue fragmentation, is 240 microns. It is said that the thinner tip breaks down easily, but by reducing metal fatigue the lifetime of the tip is longer and a larger amplitude can be obtained. As a result, hard tissue fragmentation becomes available even with a thinner tip. The handpiece is very light in weight, approximately 110 g, helping to reduce operator fatigue when in long term use. The weight is approximately one-half of conventional types. Because of the high efficiency of the electricity/vibration energy conversion rate, the handpiece does not heat up during the operation. Also, since water cooling is not necessary, the procedures before and after use are simple. Changing the handpiece during the operation is also easy.
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PMID:Ultrasonic surgical system (SONOPET) for microsurgical removal of brain tumors. 1093 22

The authors report a patient with a rare intrasellar meningioma mimicking pituitary adenoma. A 60-year-old man was admitted to our hospital for evaluation of general fatigue. He had no neurological deficit including visual function. Endocrinological tests revealed panhypopituitarism. The craniogram showed slight enlargement of the sella turcica with thinning of the dorsum sellae. CT scan and MR imaging demonstrated a homogeneously enhanced intrasellar mass with slight suprasellar extension. Partial removal of the mass was performed via the transsphenoidal approach because it was extremely firm and hemorrhagic. Histological diagnosis was transitional meningioma. The patient has been well for two years after surgery without tumor progression on MR imaging. It is mandatory to distinguish intrasellar meningioma from pituitary adenoma preoperatively because of marked difference in their treatment strategies. Despite recent advances in neurodiagnostic imaging, it may still be difficult to differentiate pituitary adenoma from intrasellar meningioma. When we re-evaluated the MR imaging, we recognized that the tumor had demonstrated specific findings, ruling out pituitary adenoma, namely bright and homogeneous enhancement, dense enhancement in the early phase on the dynamic MR study, and flow void signal within the mass. The authors emphasize that careful evaluations of MR imaging will allow the correct preoperative diagnosis in patients with intrasellar meningioma mimicking pituitary macroadenoma.
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PMID:[A case of intrasellar meningioma mimicking pituitary adenoma]. 1145 2

Patients following brain surgery for tumour were assessed using the Emotional and Social Dysfunction questionnaire on a self-rating and partner version of the questionnaire. Analyses were performed on those patients who had self-ratings following surgery for astrocytoma (n=13), meningioma (n=26), neuroma (n=13) and pituitary adenoma (n=17). Patients with astrocytoma were rated highest when compared to the other tumour groups, although all groups of patients performed more poorly on some of the individual scales compared to a matched control group of extra-cerebral neurosurgery patients and terminally ill cancer patients. A malignant (n=48) and benign (n=33) classification similarly showed a higher partner and self-rating of malignant tumour patients. Both diagnosis and location of lesion determined outcome independently. Some differences in profile and severity between patient self-ratings and partner ratings indicate the need to survey both perspectives. This study shows a broader based emotional dysfunction in these patients which includes such prominent features such as anger, helplessness, fatigue, emotional dyscontrol, indifference, and maladaptive behaviour. These results are discussed in terms of follow-up therapeutic care and the need to further explore the relationship between lesion location and emotional profile.
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PMID:Emotional and social dysfunction in patients following surgical treatment for brain tumour. 1285 80

A prospective Phase II study of temozolomide (TMZ) was conducted in 16 patients with refractory meningioma. All patients had previously been treated with surgery and involved-field radiotherapy; however, no patient had prior chemotherapy. TMZ was administered orally for 42 consecutive days every 10 weeks. Grade 3 or greater TMZ-related toxicity included anemia (25%), fatigue (18.7%), neutropenia (37.5%), seizures (6.3%), and thrombocytopenia (18.7%). No patient demonstrated a neuroradiographic complete or partial response. Time to tumor progression ranged from 2.5 to 5.0 months (median 5.0 months); survival ranged from 4 to 9 months (median 7.5 months).
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PMID:Temozolomide for treatment-resistant recurrent meningioma. 1507 29

Somnolence syndrome classically occurs in children after cranial irradiation for acute lymphocytic leukemia. Symptoms include somnolence, fever, nausea and vomiting, and headache. The authors report a 29 year-old female who developed symptoms compatible with the somnolence syndrome after completing radiation therapy for a benign meningioma near the pineal region. Five weeks after completing conformal radiation therapy (54 Gy), she developed profound fatigue, headaches, and 102-degree fevers. Physical examination and routine laboratory work were unrevealing. Imaging was not performed. Prednisone was prescribed and within 1 week her symptoms had largely resolved. This is the first report of the somnolence syndrome after focal radiation therapy. The possible etiology of the somnolence syndrome is discussed.
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PMID:Somnolence syndrome after focal radiation therapy to the pineal region: case report and review of the literature. 1657 37


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