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

Intracranial meningeal melanocytoma is an uncommon tumor that is considered benign. We formerly reported an intracranial meningeal melanocytoma. Here we report a extremely rare case of malignant transformation of this tumor. A 49-year-old man complained of a headache. Magnetic resonance scanning revealed a mass in the left frontal region. The patient underwent gross total removal of the tomor in 1994. The histological findings showed a meningeal melanocytoma. In 1998, he underwent gamma-knife surgery for local recurrence. An additional operation was performed in 1999 became tumor growth was not stopped. The tumor was partially excised by left frontal craniotomy. Histopathological examination revealed a malignant melanoma originating from a melanocytoma. The tumor was composed of a proliferation of severely atypical melanocytoid cells with slightly irregular nuclei and prominent nucleoli, associated with necrosis and hemorrhage. Mitotic figures were encountered occasionally. After six months, he died from cerebrospinal fluid dissemination of this tumor. To our knowledge, this is the first report of malignant transformation of an intracranial meningeal melanocytoma.
 ...
PMID:Malignant transformation of meningeal melanocytoma: a case report. 1460 28

Adult patients with a magnetic resonance scan suggestive of a supratentorial low-grade glioma should generally undergo at least a stereotactic biopsy to confirm the diagnosis and rule out an anaplastic glioma or a non-neoplastic lesion. Early tumor treatment should be given to patients with newly diagnosed low-grade gliomas who are over age 50 years, those who have headaches or neurologic deficits other than seizures, or those whose neuroimaging studies show tumor growth or mass effect. For younger patients presenting with seizures and no other neurologic symptoms, it is reasonable to defer therapy until there is clinical or radiographic tumor progression. When it is judged that intervention is necessary, patients should undergo the maximal surgical tumor resection, which preserves or improves neurologic function. For younger (<50 years) astrocytoma patients with a good tumor resection, radiation may be deferred until tumor progression. Early radiation should be given to astrocytoma patients who are older than 50 years of age at diagnosis (regardless of the type of surgery) or to younger patients who are judged to require early intervention but who are not candidates for aggressive surgical resection. The radiation dose for low-grade glioma should be 4500 to 5000 cGy, preferably with three-dimensional conformal ports. The same guidelines for management apply to patients with low-grade oligodendroglioma or oligoastrocytoma, except that chemotherapy is a reasonable alternative to radiation when it is judged that treatment other than surgical resection is required.
 ...
PMID:Low-Grade Gliomas in Adults. 1515 4

Cushing's disease caused by a microadenoma located near the pituitary stalk is infrequent and spontaneous remission caused by necrosis of a corticotropinoma in such location has not been reported. A 42-year-old woman with ACTH-dependent Cushing's syndrome presented on magnetic resonance imaging (MRI) a 3-mm microadenoma attached to the pituitary stalk. Treatment with ketoconazole normalized urinary free cortisol (UFC) from 433.0 to 66.0 microg/day, although it failed to reduce elevated serum androgen levels (DHEAS 4770 ng/ml). After one year, treatment was stopped and UFC rose again to 936.0 microg/day but one month later the patient presented acute headache and signs of steroid withdrawal syndrome. Endocrine evaluation showed glucocorticoid and androgen deficiency (UFC 5.0 microg/day; DHEAS < 300 ng/ml); control MRI revealed disappearance of the microadenoma. Cushingoid signs subsided and steroid replacement was initiated, proving still necessary over two years after the episode. Infarction or hemorrhage of a corticotrope adenoma could be a probable underlying mechanism although its precipitating factor is unclear. Ketoconazole withdrawal, through abrupt increase in cortisol production and/or the interruption of a hypothetical inhibitory action on cell replication followed by tumor growth and compromise of vascular supply, may be considered as possible triggering factors. To the best of our knowledge, this is the first report of spontaneous remission of Cushing's disease caused by presumed infarction of a microadenoma, unusually located in the superior rim of the pituitary, attached to the stalk.
 ...
PMID:Spontaneous remission of Cushing's disease after disappearance of a microadenoma attached to the pituitary stalk. 1563 98

Prolactinomas are the most frequent pituitary tumors. Treatment of infertility in such tumors usually is very successful. On the other hand, reports of pituitary tumor growth during pregnancy have been described since bromocriptine started to be used. Since then, dopamine agonists (DA) have been increasingly used as the first-choice treatment of prolactinomas, with surgery being reserved for resistance or persistent intolerance to DA or for special situations. More recently other DA, such as quinagolide and cabergoline have shown better tolerance than bromocriptine with similar or greater efficacy. Cabergoline is now the first choice drug but its use in pregnancy is still under evaluation. We followed 71 term pregnancies in women bearing microprolactinomas. Of the 22 patients with previous surgery, none presented symptoms of tumor growth. Of the 41 pregnant patients treated with bromocriptine alone, only one (2.4%) presented with headaches, which regressed with drug reintroduction. Fifty one term pregnancies in patients with macroprolactinomas were followed by us. Of those, 21 were in patients with previous surgery and none of them presented clinical evidence of tumor growth. On the other hand, of the 30 patients treated only with pre-gestational bromocriptine, 11 (37%) manifested complaints related to tumor growth. A non-hormonal contraceptive should be the use along with a DA drug until tumor shrinkage within sellar boundaries has been evidenced. After pregnancy has been confirmed, the DA can be withdrawn and the patient must be closely followed. If tumor expansion is suspected, confirmation can be made through MRI and by visual field testing. Reintroduction of bromocriptine in such cases can lead to tumor reduction and clinical improvement. Surgery can also be employed as treatment for symptomatic tumor growth in pregnancy.
 ...
PMID:Prolactinomas and pregnancy. 1641 Oct 66

A 75-year-old woman presented with a small right vestibular schwannoma which enlarged and then spontaneously regressed during conservative management. The tumor increased in size from 5.2 to 16.7 mm over 7 years with worsening symptoms of tinnitus, dizziness, and headache. The tumor then regressed to 8.2 mm and the symptoms improved for 4 years without further treatment. Changes in tumor growth should be carefully monitored during conservative management of patients with vestibular schwannoma.
 ...
PMID:Spontaneous regression of a growing vestibular schwannoma. 1718 87

Seizures are a common complication of metastatic brain tumors (MBT), affecting approximately 27-50% of all patients during the course of their illness. Treatment of tumor-induced seizures is often inadequate with traditional antiepileptic drugs (AED) due to a variety of factors, including activation of glutamatergic NMDA receptors, alterations of neuronal input pathways, and tumor growth. Levetiracetam (LEV) is a 2nd generation non-enzyme inducing AED with a novel mechanism of action, binding to neuronal synaptic vesicle protein SV2A, that has been previously shown to reduce seizure activity in patients with primary brain tumors. Due to its unique mechanism of action, it has been postulated that LEV may also be effective in controlling seizures from MBT. A retrospective chart review was performed of all Neuro-Oncology Center patients with MBT who had received LEV for seizure control. Thirteen patients were reviewed with a median age of 55.1 years (range: 34-70). Six patients had breast cancer, five had lung cancer, and two had melanoma. LEV was used as an add-on AED in seven patients (54%) and as monotherapy in six patients (46%), with a median dose of 1,000 mg/day (range: 500-3,000). The baseline median seizure frequency was one ictal event every other day. After the addition of LEV, the median seizure frequency was reduced to 0 per week. The seizure frequency was reduced to less than 50% of the pre-LEV baseline in 100% of patients (P=0.0002, Sign test), with 10 patients (77%; confidence interval: 46-95%) noting complete seizure control. The most common adverse event was somnolence and headache, noted in 3 of 13 patients (23%). LEV was very effective and well tolerated in MBT patients with seizures and should be considered for add-on therapy or as a substitute AED for monotherapy.
 ...
PMID:Retrospective analysis of the efficacy and tolerability of levetiracetam in patients with metastatic brain tumors. 1743 42

We report a case of hemorrhagic giant cell tumor (GCT) of the temporal bone in a 77-year-old woman. The patient suffered from sudden-onset headache and vomiting associated with left temporal hemorrhage. MRI revealed a left temporal extradural mass lesion expanding to the subtemporal fossa, showing strong hypointensity on T(2)-weighted imaging. Subsequent MRI revealed tumor growth with multiple cystic components at 1-month follow up. The tumor was found to be a GCT associated with recent intratumoral hemorrhage and abundant hemosiderin pigmentation. T(2)-weighted MRI of the GCT strongly supported hemosiderin deposition. Secondary formation of cystic components in the GCT can also reflect prior hemorrhage and indicate the progression of shape modification. A literature review revealed that hemosiderin deposition in this rare entity is not as rare as previously thought and that massive intratumoral hemorrhage may occur.
 ...
PMID:Giant cell tumor of the temporal bone with intratumoral hemorrhage. 1855 12

Today, treatment recommendations for patients with all types of gliomas are based on light microscopic evaluation of tumor tissue with no allowance for genetic variability. Oligodendrogliomas are treated in a uniform manner with, as yet, no unique therapeutic approach or targeted therapy for those harboring a codeletion of chromosomes 1p and 19q. Surgical resection and radiotherapy are the standards-of-care for patients with oligodendrogliomas. Surgery improves symptoms, especially headache or seizures, and radiotherapy controls tumor growth for most patients. By extrapolation from randomized trials of glioblastoma, radiotherapy likely prolongs survival. Uncertainties persist about the timing of radiotherapy in the management of patients with low-grade oligodendrogliomas, but a superior antitumor treatment has yet to emerge. That said, the recognition that oligodendrogliomas with 1p/19q loss are sensitive to current therapies and slowly growing is already influencing our management of patients with this type of glioma, spawning trials in which patients are selected by molecular signature.
 ...
PMID:Gliomas with 1p/19q codeletion: a.k.a. oligodendroglioma. 1906 May 98

Rosette-forming glioneuronal tumor (RGNT) of the fourth ventricle is a rare tumor included as a novel glioneuronal neoplasm in the 2007 World Health Organization classification of brain tumors. A 15-year-old female patient presented with RGNT of the fourth ventricle manifesting as headache persisting for one month. Magnetic resonance imaging disclosed a nonenhanced solid mass in the fourth ventricle and vermis. The tumor was gross totally resected. Histological examination revealed biphasic neurocytic and glial architecture. The neurocytic component consisted of uniform neurocytes forming neurocytic rosettes and perivascular pseudorosettes. Only 31 cases of RGNT have been reported. RGNT of the fourth ventricle should be considered in the differential diagnosis of infratentorial lesions in young adults. The prognosis is benign, but relatively aggressive behaviors such as tumor growth, recurrence, and acute deterioration due to intratumoral hemorrhaging can occur. Surgical resection requires care to prevent major surgical morbidities associated with lesions invading the cerebellum or brainstem.
 ...
PMID:Rosette-forming glioneuronal tumor of the fourth ventricle--case report. 2033 73

Tyrosine kinase receptors play an important role in tumor angiogenesis and, their implication in epithelial thyroid tumor growth has been highlighted. Sunitinib is a novel tyrosine kinase inhibitor, approved in 2006 by Food and Drug Administration for the treatment of advanced renal cell and gastrointestinal stromal tumors. Preliminary promising results have been also obtained in patients with RAI-resistant thyroid neoplasia. In the current study, our experience on 9 patients with advanced thyroid epithelial cancer is analyzed and discussed in relation to the new patents in this field. According to RECIST criteria, partial response was obtained in 5/9 (55.5%) patients at 3 months and in 6/9 (66.6%) at 6 months. Median treatment follow-up was 13.0 months and median overall survival and progression-free survival were 20 [95% confidence interval (CI) 9.3 - 30.6] and 21 months (95% CI 6.9 - 35.1), respectively. One case of severe thoracic hemorrhage was observed, the most common adverse events being represented by fatigue, (44.4% ), skin rash (33.3% ), headache (33.3% ), and one case each of hypertension, macrocytosis and acute pneumonia. These results confirm sunitinib as a potential useful tool for the treatment of advanced thyroid cancers and may open the way for new patents of molecules with more specific target selectivity.
 ...
PMID:Off-label use of sunitinib in patients with advanced, epithelial thyroid cancer: a retrospective analysis. 2253 21


<< Previous 1 2 3 4 5 6 Next >>