Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 48-year-old female presented with headache and limitation of upward gaze. She had a history of total gastrectomy for gastric adenocarcinoma 2 years previously. Computed tomography with contrast medium and T1-weighted magnetic resonance (MR) imaging with gadolinium showed ring-like enhancement of a solitary mass in the pineal region with obstructive hydrocephalus. T2-weighted MR imaging showed the tumor as hypointense. This MR imaging finding complicated the preoperative diagnosis, but malignancy was suspected from the medical history. The tumor was subtotally resected via the occipital transtentorial approach with a rigid endoscope. Histological examination of the surgical specimen revealed adenocarcinoma cells with extensive coagulation necrosis, which might have contributed to the hypointensity on T2-weighted MR imaging. Correct diagnosis of metastatic adenocarcinoma based only on MR imaging may be difficult in such cases, but metastatic adenocarcinoma of the pineal region must be considered in the differential diagnosis of pineal tumors.
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PMID:Pineal region metastasis appearing as hypointensity on T2-weighted magnetic resonance imaging--case report. 1198 97

We describe a case of a 70-year-old patient with sudden onset of gait ataxia, headache, dizziness and dysarthria. Magnetic resonance imaging revealed a solitary lesion in the left cerebellar hemisphere with strong and irregular enhancement of the contrast medium, surrounded by extensive edema. Rectal examination revealed an abnormally enlarged and stiff left prostate lobe, and ultrasound-guided transrectal biopsies showed prostate adenocarcinoma of mild differentiation. Neurosurgical intervention and histopathologic examination revealed metastatic prostate adenocarcinoma. The patient underwent orchiectomy and was given antiandrogens. He is still alive and closely followed. According to the literature, prostate cancer presenting as a solitary cerebellar metastasis is an extremely rare clinical problem.
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PMID:Prostate cancer presenting as a solitary cerebellar metastasis. A case report and review of the literature. 1200 53

While solitary sphenoid sinus disease is uncommon, primary isolated sphenoid sinus carcinoma is extremely rare. We describe a case of isolated sphenoid sinus adenocarcinoma in a 68-year-old man. The patient presented with a persistent headache and with diplopia secondary to complete ophthalmoplegia. Paranasal sinus tomography showed a soft-tissue mass obliterating the sphenoid sinus and infiltrating the cavernous sinuses. The histological diagnosis on endoscopic intranasal biopsy was adenocarcinoma. The patient underwent radiotherapy, and his symptoms resolved. However, multiple bone metastases developed 6 months after he was diagnosed. This report is significant in that it presents a rare condition and highlights the features of primary sphenoid sinus lesions.
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PMID:Isolated sphenoid sinus adenocarcinoma: a case report. 1210 31

We report three cases of meningeal carcinomatosis that metastasized from lung cancer. The patients were men of 73, 65 and 77 years old. The histological type was adenocarcinoma in all cases. At the time of emergence of neurological symptoms such as nausea, headache and cataplexy, enhanced CT of the brain did not disclose brain metastasis. Although brain MRI failed to detect abnormal meningeal findings in cases 1 and 2, meningeal carcinomatosis was diagnosed by cerebrospinal fluid cytology in all three cases. As for treatment, in case 1, methotrexate and prednisolone were administered intrathecally, while the optimum supportive care was given in cases 2 and 3. Because it is difficult to detect meningeal carcinomatosis by brain CT and MRI alone, careful neurological observation and cerebrospinal fluid cytology are necessary for its diagnosis.
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PMID:[Three cases of metastatic meningeal carcinomatosis from lung cancer]. 1232 39

A 27-year-old woman was admitted to our hospital because of headache, fever and right neck pain. Neurological examination revealed mild meningeal signs, and hyper-reflexia in all extremities. In the laboratory tests, white-cell count was 13,000/mm3, rheumatoid factor(RF) and C-reactive protein(CRP) were positive. The cerebro-spinal fluid showed pleocytosis (56/mm3, neutorophils and lymphocytes were 26 and 28, respectively). Thus, she was diagnosed as aseptic meningitis. A few days later, she had weakness and dysesthesia of the right face and the left extremities. Pulse therapy with intravenous methylprednisolone was started. A magnetic resonance imaging (MRI) of the brain showed a hemorrhagic infarction in the right parietal lobe. In hemostatic markers, thrombin-antithrombin III complex(TAT; 106 ng/dl), D-dimer 1234 ng/dl, prothrombin fragment 1 + 2(F1 + 2; 2.36 nmol/L), beta-thromboglobulin (beta TG; 4,300 ng/dl) and platelet factor 4 (PF-4; 1,770 ng/dl) were extremely elevated. On duplex ultrasonography, a low echo lucent plaque was observed at the right internal carotid artery and the mean blood flow velocity in the right carotid artery was decreased. She was placed on oral prednisolone and warfarin for suspected stroke due to hypercoagulability associated with vasculitis. Afterwards, she discharged from our hospital. Two months later, she was readmitted to our hospital because of irregular menses and vaginal bleeding. Endometrial uterus biopsy was conducted, which revealed a grade I endometrioid adenocarcinoma. She was under total uterectomy without tumor recurrence. After the radical operation, white-cell count, RF, CRP, TAT, D-dimer, F1 + 2, and beta TG were normalized, and the mean flow velocity of the right common carotid artery was increased. Thereafter, she did not experience stroke recurrence. Therefore, we speculated that she had stroke due to hypercoagulability in association with malignancy, that is Trousseau's syndrome. We also assumed that aseptic meningitis, brainstem encephalitis associated with vasculitis in this patient are other clinical variants of paraneoplastic syndrome through immunological mechanisms associated with malignancy. We emphasize that patients with Trousseau's syndrome can be associated with other paraneoplastic manifestations such as vasculitis as seen in this patient.
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PMID:[A young patient with endometrioid adenocarcinoma who suffered Trousseau's syndrome associated with vasculitis]. 1247 93

A case of metastasis to the sella turcica from a follicular adenocarcinoma of the thyroid gland is presented. Metastasis to this site is rare and review of the literature reveals only 12 cases of metastatic thyroid carcinoma involving the sella turcica and pituitary gland. The optimal treatment strategy is still to be determined. A 43-year-old woman presented with headache, nausea, visual impairment and galactorrhea. An MRI scan of the cranium revealed an enhancing destructive sellar lesion. The patient underwent transsphenoidal removal of the lesion to alleviate visual loss. The histological features of the sellar tumor were identical to those of a follicular adenocarcinoma partially removed from the thyroid gland 22 months earlier. Total thyroidectomy followed by three courses of iodine-131 ablation enhanced with synthetic thyrotropin and thyroid hormone suppression therapy was instituted. The post-operative course was satisfactory with improved vision and ceased galactorrhea. This case was successfully treated with a combination of surgical removal, iodine-131 ablation and hormone suppression therapy, which resulted in disease control duration of four years. Sella turcica metastases of thyroid carcinoma are exceedingly rare and currently there are no established therapeutic guidelines.
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PMID:Sella turcica metastasis from follicular carcinoma of thyroid. 1497 61

We report a rare case of skull metastasis from ampulla of Vater adenocarcinoma in a patient with controlled primary neoplasm. This 65-year-old Korean man presented with headache and painful parietal scalp swelling, but he did not show any neurological deficits. Computed tomography revealed an osteolytic mass that invaded and expanded through the skull tables in full-thickness. On magnetic resonance images following Gadolinium injection, the mass appeared slightly hypointense signal on all sequences and intense heterogeneous enhancement. He underwent surgical excision with artificial grafting of calvaria and dura. Postoperative radiation therapy was ensued for metastatic adenocarcinoma, and he was well for the follow-up period of 3 months. To the best of our knowledge, this is the first such case that involved the skull.
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PMID:Skull metastasis from ampulla of Vater adenocarcinoma: case report. 1507 55

We treated a patient with lung adenocarcinoma who responded to chemotherapy with vinorelbine (VNR) plus carboplatin (CBDCA) on an outpatient basis. The patient was a 68-year-old man. He visited a local physician complaining of wet coughing, headache and general fatigne. The symptoms remained unchanged and the patient was admitted to our department for treatment in June 2000. A massive shadow in the right upper lobe and multiple cerebral metastases were found. Based on this, the diagnosis was lung adenocarcinoma (T3N2M1, clinical stage IV). Whole-brain irradiation and systemic chemotherapy were initiated from July 2000. The patient received 1 course of systemic chemotherapy with vindesine (VDS) plus cisplatin (CDDP) on an inpatient basis. This regimen was replaced with combination therapy of paclitaxel (TXL) plus CBDCA in the outpatient setting, along with VNR plus CBDCA due to side effects caused by TXL. The cerebral metastases almost disappeared due to whole-brain irradiation. Chest CT after 3 courses revealed a reduction in primary tumor size. The VNR plus CBDCA combination therapy was continued for a further 6 courses. As the result, neither the primary tumor nor the cerebral metastases enlarged. The combination therapy with VNR plus CBDCA seems to be a useful regimen that can maintain high QOL and be conducted for a long term on an outpatient basis.
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PMID:[Advanced non-small cell lung cancer responded to both vinorelbine and carboplatin over long-term outpatient treatment]. 1544 64

A 74-year-old Filipino man presented with new-onset partial-complex seizures. Eight months earlier he had a subtotal gastrectomy for adenocarcinoma classified as T1 N0M0 stage IA. He was irradiated. Two months later, he became confused and developed rhythmic, seizure-like movements of the extremities. A head CT revealed a 2 cm. right frontal lobe mass. On MRI, the mass exhibited ring enhancement and was surrounded by edematous white matter. The patient denied headache, weakness or constitutional symptoms. CT of the chest and abdomen revealed no evidence of metastatic spread or other abnormalities. His seizures were controlled with fosphenytoin and dexamethasone. Preoperatively the frontal lobe lesion was considered most likely to be either a metastatic or primary tumor. Resection of the frontal lobe lesion revealed a firm gliotic cystic mass. Crush preparations and frozen sections showed acute and chronic inflammation, gliosis, fibrosis, and many foreign body giant cells reacting to parasitic larval tissue. Intact and necrotic larval parts were surrounded by gliotic brain tissue containing foreign body giant cells, macrophages, and lymphocytes. However, eosinophils were not seen. Finally a refractive fragment resembling a hooklet and a fragmented scolex were identified that made a diagnosis of cysticercosis certain.
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PMID:January 2004: elderly Filipino man with frontal lobe tumor. 1544 90

Although virtually any systemic malignancy is capable of metastasizing to the brain, ovarian carcinoma, one of the more common female genital malignancies, is one of the rarer forms of brain metastases. In general, the outcome for ovarian carcinoma with brain metastases is extremely poor as most of these patients have widespread lesions elsewhere. This report describes the first known case of multiple cerebral and leptomeningeal metastases as the initial manifestation of ovarian carcinoma in a 41-year old woman who presented with a one-week history of headache, vomiting and confusion. CT scan of the brain was unremarkable, but lumbar puncture revealed atypical cells in the CSF. MRI scan of the brain showed multiple small enhancing lesions. Craniotomy for excision of one of these lesions demonstrated metastatic adenocarcinoma. A large ovarian tumour identified on pelvic CT scan was resected and the patient subsequently received chemotherapy and radiotherapy. Unfortunately she continued to decline and died within six months. Unlike primary tumours such as malignant melanoma, ovarian carcinoma does not have a predilection for the central nervous system (CNS), but the rare instances with CNS involvement occur at an advanced stage of the disease. Once the CNS is involved, the outcome is abysmal, even with multimodality therapy. It is extremely unusual for ovarian carcinoma to present with multiple CNS involvement.
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PMID:Multiple cerebral and leptomeningeal metastases from ovarian carcinoma: unusual early presentation. 1611 53


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