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 case of alveolar soft-part sarcoma with multiple cerebral metastases in addition to multiple lung and bone metastases is reported. This is a rare tumor which thus far has only been recognized as a malignant soft tissue tumor with great uncertainty. A 24-year-old man with a chief complaint of left frontal headache was admitted to our unit on September 26, 1994. A tumor of the right forearm had been surgically removed 9 years previously, and surgery had been followed by two courses of chemotherapy with vincristine, cyclophosphamide and actinomycin-D and subsequent irradiation for bone metastasis. The chemotherapy, however, did not have any clear effect. Neurological examination at the time revealed only bilateral papilledema, but CT and MRI scan of the brain showed a round mass in the left occipital lobe with homogeneous enhancement and another small mass was detected in the right occipital lobe. A cerebral angiogram showed a vascular tumor. The preoperative diagnosis was multiple cerebral metastases of alveolar soft part sarcoma. Left occipital craniotomy was performed on October 12, 1994, and the tumor was completely removed by lobectomy. Specimens of the tumor showed typical histological features of alveolar soft-part sarcoma. Whole-brain radiotherapy was administered postoperatively, and the patient is well neurologically without right homonymous hemianopsia. The clinical features of alveolar soft-part sarcoma are discussed. Only a few cases have been reported in the literature, but the most frequent site of the primary lesion has been the lower extremities, and cerebral metastasis has not been rare. All efforts should be focused on discovering this tumor in the early stage because surgical removal can yield good results, and radiotherapy is thought to be effective in terms of patient "quality of life".
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PMID:[A case of alveolar soft-part sarcoma with cerebral metastases]. 886 39

A case of Collet-Sicard Syndrome caused by skull base metastasis of prostate carcinoma is reported. A fifty-five years old man presenting multiple lymph node and bone metastases of prostate carcinoma was treated with LH-RH agonist and Flutamide, which induced transient decrease in serum PSA levels and size of lymph node metastases. After 8 months of the treatment, the patient started complaining headache, dysphagia and dysarthria. Brain CT and MRI demonstrated a soft tissue mass replacing left pyramidal bone and occipital bone around left jugular foramen. The tumor was diagnosed as skull base metastasis of the prostate carcinoma and was treated with 50Gy of radiation. The symptom improved after the radiation but died of the disease in 4 months. The autopsy revealed the skull base metastasis of the prostate carcinoma and the tumor was proved to be poorly differentiated adenocarcinoma, which was positively stained by anti-PSA antibody. The case showed cranial nerve palsy of IX to XII, which is usually called Collet-Sicard syndrome. This is the third case report of Collet-Sicard syndrome caused by the skull base metastasis of prostate carcinoma, and it is the first case in Japan.
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PMID:[A case of Collet-Sicard syndrome caused by skull base metastasis of prostate carcinoma]. 1089 82

Bisphosphonates are potent inhibitors of bone resorption and provide a therapeutic benefit for patients with bone metastases. Zoledronic acid is a highly potent, nitrogen-containing bisphosphonate. In the present trial, we assessed the safety and tolerability of increasing doses of zoledronic acid and its effects on urinary markers of bone resorption in cancer patients with bone metastases. Fifty-nine cancer patients with bone metastases were enrolled sequentially into one of 8 treatment groups in the core protocol. Each patient received a 5-min i.v. infusion of 0.1, 0.2, 0.4, 0.8, 1.5, 2, 4, or 8 mg zoledronic acid monthly for 3 months. Patients were monitored for clinical findings, adverse events, electrocardiograms, markers of bone resorption, as well as routine hematology, blood chemistries, and urinalysis. Thirty patients who demonstrated a radiographic response to treatment or stable disease in the core protocol were enrolled in a humanitarian extension protocol and continued to receive monthly infusions. Zoledronic acid was well tolerated at all dose levels. Adverse events reported by >10% of patients included skeletal pain, nausea, fatigue, upper respiratory tract infection, constipation, headache, diarrhea, and fever. Three patients in the core protocol and one patient in the extension protocol experienced grade 3 skeletal pain, "flu-like" symptoms, or hypophosphatemia, which were possibly related to treatment; all recovered completely. Adverse events were reported with similar frequency across all of the dosage groups. Zoledronic acid resulted in sustained, dose-dependent decreases in urinary markers of bone resorption. Zoledronic acid was safe and well tolerated and demonstrated potent inhibition of bone resorption.
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PMID:A phase I dose-ranging trial of monthly infusions of zoledronic acid for the treatment of osteolytic bone metastases. 1129 37

Control of malignant pain and related symptoms is paramount to clinical success in caring for cancer patients. To achieve the best quality of life for patients and families, oncologists and palliative care clinicians must work together to understand problems related to psychologic, social, and spiritual pain. Pain is the primary problem targeted for control using the World Health Organization's (WHO) analgesic ladder. This article focuses on increased knowledge of analgesic action that may enable expansion of the WHO analgesic ladder to fulfill the broader objectives of palliative medicine. We discuss clinical experience with several classes of drugs that are currently used to treat cancer pain: 1) nonsteroidal anti-inflammatory drugs, with emphasis on cyclooxygenase-2 inhibitors; 2) opioid analgesics, with specific emphasis on methadone and its newly recognized value in cancer pain; 3) ketamine, an antagonist at N-methyl-d-aspartate receptors; and 4) bisphosphonates, used for pain resulting from bone metastases. New concepts that compare molecular actions of morphine at excitatory opioid receptors, and methadone at nonopioid receptor systems, are presented to underscore the importance of balancing central nervous system excitatory (anti-analgesic) versus inhibitory (analgesic) influences.
Curr Pain Headache Rep 2001 Jun
PMID:Advances in cancer pain management. 1130 14

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

Percutaneous vertebroplasty is a minimally invasive procedure that is effective in the treatment of pain resulting from pathologic compression fractures, osteolytic bone metastases from solid tumors, myeloma, vertebral hemangioma, and osteoporotic compression fractures. A discussion of a patient with severe, aggressive metastatic breast cancer to the spine with compression and osteolysis of multiple lumbar vertebral bodies is presented. Despite treatment with opiates, chemotherapy, radiation therapy, and the implantation of a morphine pump, her pain was not adequately treated until she underwent multilevel vertebroplasty. The clinical and technical application of vertebroplasty in the context of the management of vertebral pain of malignant origin is presented as an integral part of multidisciplinary pain management.
Curr Pain Headache Rep 2002 Dec
PMID:Percutaneous vertebroplasty in the management of a patient with malignant pain and associated osteolytic compression fractures. 1241 2

The endothelin (ET) axis represents a novel and exciting target in the treatment of prostate cancer. ET-1, acting primarily through the endothelin A receptor (ET(A)), is integrally involved in multiple facets of prostate cancer progression, including cell growth, inhibition of apoptosis, angiogenesis, development and progression of bone metastases, and mediation of pain responses. Clinical trials with the ET(A) antagonist, atrasentan, have demonstrated good tolerability, with the most common adverse events being headache, rhinitis, and peripheral edema. These trials have demonstrated statistically significant improvements in pain measures, prostate-specific antigen (PSA) kinetics, biologic markers of bone changes, and development of bone metastases. There have also been consistent improvements in time to progression, although not always statistically significant. Ongoing studies in a variety of patient populations will better define the role of ET receptor antagonists in the treatment of men with prostate cancer. In this article, we review the biology and pathophysiology of the ET axis in prostate cancer, critically analyze the major clinical trials reported to date, and discuss some emerging data and how it may impact the way we proceed in the future with the development of this class of drugs in prostate cancer.
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PMID:Endothelin receptor antagonists in the treatment of prostate cancer. 1457 15

Extracranial bone metastasis from glioblastoma multiforme (GBM) has rarely been reported in the literature, and most metastatic GBMs are multiple bone metastases. The authors describe the first case of a GBM with metastasis only to the axis. This 42-year-old man presented with a 2-month history of headache, nausea, vomiting, and disorientation. Magnetic resonance imaging demonstrated a right temporal tumor, which was diagnosed as a GBM based on tumor resection. The patient was treated using radiation (6000 cGy) and the intravenous administration of nimustine hydrochloride. Eighteen months thereafter, he experienced the sudden onset of neck pain. Magnetic resonance studies revealed a tumor in the axis that was diagnosed as GBM based on biopsy procedure.
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PMID:Glioblastoma multiforme metastasis to the axis. Case report. 1579 92

Painful metastatic bone disease remains a challenge for physicians. The treatment choices available are wide and varied, with each having its appropriate place in the management of painful bone metastases. Radiotherapy remains the mainstay of treatment with or without surgery. Advances in understanding the intricate pathway responsible for pain generation and the addition of agents such as bisphosphonates to the physician's armamentarium further assist in the management of painful bone metastases.
Curr Pain Headache Rep 2006 Aug
PMID:Metastatic bone cancer pain: etiology and treatment options. 1683 44

Catecholamine-producing tumors may arise in the adrenal medulla (pheochromocytomas) or in extraadrenal chromaffin cells (secreting paragangliomas). Their prevalence is about 0.1% in patients with hypertension and 4% in patients with a fortuitously discovered adrenal mass. An increase in the production of catecholamines causes symptoms (mainly headaches, palpitations and excess sweating) and signs (mainly hypertension, weight loss and diabetes) reflecting the effects of epinephrine and norepinephrine on alpha- and beta-adrenergic receptors. Catecholamine-producing tumors mimic paroxysmal conditions with hypertension and/or cardiac rhythm disorders, including panic attacks, in which sympathetic activation linked to anxiety reproduces the same signs and symptoms. These tumors may be sporadic or part of any of several genetic diseases: familial pheochromocytoma-paraganglioma syndromes, multiple endocrine neoplasia type 2, neurofibromatosis 1 and von Hippel-Lindau disease. Familial cases are diagnosed earlier and are more frequently bilateral and recurring than sporadic cases. The most specific and sensitive diagnostic test for the tumor is the determination of plasma or urinary metanephrines. The tumor can be located by computed tomography, magnetic resonance imaging and metaiodobenzylguanidine scintigraphy. Treatment requires resection of the tumor, generally by laparoscopic surgery. About 10% of tumors are malignant either at first operation or during follow-up, malignancy being diagnosed by the presence of lymph node, visceral or bone metastases. Recurrences and malignancy are more frequent in cases with large or extraadrenal tumors. Patients, especially those with familial or extraadrenal tumors, should be followed-up indefinitely.
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PMID:Pheochromocytomas and secreting paragangliomas. 1715 52


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