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)

The occurrence of clinically symptomatic intraocular metastases as an initial manifestation of primary neoplasm is rare event. The recognition of metastatic ocular tumors is important since they indicate a poor prognosis. Prompt diagnosis and treatment can significantly improve the quality of life for these patients. We report the case of a 48-year-old man presenting with a two-week history of left sided intraocular pain with blurring of vision and headache, which are the first signs of small-cell lung carcinoma.
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PMID:Bilateral choroidal metastases as an initial manifestation of small-cell carcinoma of the lung. 1661 20

Brain metastases are frequent features during the course of patients with lung carcinoma. The aim of this study was to investigate prognostic factors for patients with brain metastasis from lung cancer. Eighty-eight patients with brain metastasis from lung cancer were enrolled in the study. Eighty-two of cases were male, six were female and the mean age was 57.5 +/- 10.4 years. The most common symptoms were headache (32.9%) and dizziness (32.9%). Fifty-two (59.1%) patients had solitary brain metastasis and the most frequent metastasing site was parietal lobe (34.1%). The median survival times were 3 months after diagnosis of lung carcinoma and 1.5 months after diagnosis of brain metastasis. Although the absence of brain metastasis at the moment of diagnosis, metachronous metastasis, central localization of the tumour, chemotherapy administration and surgical treatment of brain metastasis are good prognostic factors affecting survival after the diagnosis of lung carcinoma, the positive factors affecting survival after brain metastasis are central localization of tumour, chemotherapy administration and surgical treatment of brain metastasis. In conclusion, performing the combination of cranial radiotherapy, chemotherapy, surgical therapy and supporting therapy should be evaluated in all appropriate patients with brain metastasis from lung cancer.
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PMID:[Factors affecting the prognosis in patients with primary lung cancer and brain metastases]. 1700 40

We present a 74-year-old male ex-smoker presenting with a 6-week history of personality change, confusion and headache. Magnetic resonance imaging revealed multiple supratentorial and infratentorial parenchymal masses, predominately in the frontal and parietal lobe white matter. A thin enhancing halo was demonstrated with central low signal intensity on T(1)-and T(2)-weighted imaging compatible with calcification. A tiny extra-axial lesion was also noted near the right cerebellopontine angle. Computed tomography (CT) scan confirmed the finding of a 'target' lesion with a central core of calcification and a ring of enhancement. The 'target sign' of intracerebral tuberculomata was first described in 1979 and reported to be pathognomic for this diagnosis in 1988. However, cerebral tuberculosis was considered unlikely clinically because the patient had recently completed a 12-month course of therapy for Mycobacterium avium complex respiratory infection with agents also active against Mycobacterium tuberculosis. He was afebrile and blood tests did not support an inflammatory process. Subsequent histopathology demonstrated metastatic papillary adenocarcinoma and immunohistochemical studies revealed the origin to be that of primary lung carcinoma. A spiculated pulmonary nodule was seen on CT scan but previous bronchoscopy failed to demonstrate malignant cells. In summary, the 'target sign' is a non-specific radiologic finding but most commonly indicates cerebral tuberculoma or metastatic adenocarcinoma in the appropriate clinical context.
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PMID:Metastatic adenocarcinoma mimicking 'target sign' of cerebral tuberculosis. 1708 1

A 62-year-old male developed headache, restlessness and left hemiparesis three months after being diagnosed with advanced lung cancer. Computed tomography on admission revealed a crescent-shaped, mixed intensity area in the right fronto-parietal subdural region and multiple tumors in the brain parenchyma. Under a diagnosis of chronic subdural hematoma and multiple brain metastases due to lung carcinoma, burr hole irrigation was performed. Adenocarcinoma cells were found in the dura matter and hematoma. Nontraumatic chronic subdural hematoma secondary to dural metastasis is a very rare condition. Only 52 cases of such spontaneous subdural hematoma have been reported. We describe the clinical features and discuss the mechanism referring to the pertinent literature.
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PMID:[A case of subdural hematoma associated with dural metastasis of lung cancer]. 1749 48

The author reports herein a case of small cell carcinoma of the brain without extracranial tumors by serial imaging modalities. A 75-year-old man presented with headache. Brain CT and MRI revealed a solitary cystic tumor (5 x 6 x 7 cm) in the left occipital lobe. Blood laboratory test revealed no significant findings. Preoperative diagnosis was a primary or metastatic brain tumor. Preoperative systemic examinations including CT, MRI and PET revealed no extracranial tumors. Tumorectomy was performed. Pathologically, the tumor was small cell carcinoma positive for four types of pancytokeratins, cytokeratin (CK) 7, CK 18, thyroid transcriptional factor-1 (TTF-1), CD56, chromogranin, synaptophysin, neuron-specific enolase, p53 protein, KIT, PDGFRA, and Ki-67 antigen (labeling = 100%). It was negative for high molecular weight CK, CK5/6, CK14, CK19, CK20, PE10, epithelial membrane antigen, vimentin, CEA, desmin, S100 protein, CA19-9, alpha-smooth muscle actin, CD34, p63, and CD68. The pathologic examination strongly suggested primary small cell lung carcinoma. However, repeated serial imaging modalities including systemic CT, MRI and PET revealed no extracranial tumors. The serial sputum cytology was always negative. The patient was treated with radiation and cisplatin-based chemotherapy, and no tumors were found seven months after the operation. The present case suggests that there are small cell carcinomas with a solitary brain metastasis without a radiologically detected primary site. In the present case, primary small cell brain carcinoma cannot be excluded completely, although such a case has not been reported in the literature.
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PMID:Small cell carcinoma of the brain without extracranial involvement by serial CT, MRI and PET. 2022 32

Lung cancer is the leading cause of cancer-related death for both men and women worldwide, and lung cancer also has the highest morbidity and mortality rate among all cancers in China. Chemotherapy (CT) is the most effective and most widely used treatment for lung cancer. Nausea and vomiting are still among the most unpleasant side effects of chemotherapy, especially during highly emetogenic chemotherapy. The standard therapy for preventing chemotherapy-induced nausea and vomiting (CINV) is 5-hydroxytryptamine 3 (5-HT3) receptor antagonists. Palonosetron is a highly potent second-generation selective 5-HT3 receptor antagonist with stronger binding affinity for the 5-HT3 receptor. Palonosetron showed a high antiemetic activity in preclinical study and pivotal trails enrolling patients treated with moderately or high antiemetic activity drugs. Aim of the study was to verify the activity and safety of palonosetron in patients affected by non-small-cell lung carcinoma (NSCLC) and treated with chemotherapy. Patients with stage II-IV NSCLC and receiving chemotherapy entered into the trial. Informed written consent was required. Patients were randomized to received palonosetron or ondasetron. A single pretreatment dose of palonosetron 0.25 mg intravenous followed was administered. Nausea and vomiting were evaluated over 7-day period. Also the adverse effects were reported. Adverse events were evaluated according to the NCI-CTC criteria. Eighty-nine patients were enrolled into the study. The complete responses during the acute phase were 95.4 and 93.3%, respectively. The main side effects were headache 4.5%, constipation 15.7%, anxiety 2.3%. Palonosetron is a very active antiemetic drug for the prevention of nausea and vomiting in NSCLC patients received chemotherapy.
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PMID:Palonosetron for prevention of acute and delayed nausea and vomiting in non-small-cell lung carcinoma patients. 2060 63

Vascular disrupting agents (VDAs) are an exciting new group of targeted therapies under active clinical research in many solid tumors, in particular, lung cancer. Small-molecule VDAs are the focus of current clinical research, and consist of the flavonoids and the tubulin-binding agents. Toxicities of single-agent VDAs are characterized by acute, transient, and generally noncumulative side effects including headaches, nausea and vomiting, tumor pain, hypertension, and tachycardia. Flavonoid agents can also cause infusion site pain, visual disturbances, electrocardiac abnormalities, and symptoms consistent with an acute release of serotonin. Tubulin-binding agents can result in cardiac ischemia, abdominal pain, neuromotor abnormalities and cerebellar ataxia, and acute hemodynamic changes. Clinical trials investigating VDAs in combination with traditional chemotherapy have also shown the potential for significant pharmacologic and adverse toxicity interactions. Further research will need to focus on pharmacokinetic and pharmacodynamic parameters to optimize dosing schedules, determine effective combinations with chemotherapy, and minimize toxicities associated with VDAs.
Clin Lung Cancer 2011 Jan
PMID:Classification and toxicities of vascular disrupting agents. 2127 75

Metastases in the sellar region are rare and are frequently found incidentally or in necropsies. Only 7% are reported to be symptomatic. Diabetes insipidus, anterior pituitary dysfunction, visual field defects, headache/pain and ophthalmoplegia are the most commonly reported symptoms. We present the cases of two male patients with a small-cell lung carcinoma whose first clinical symptoms were due to pituitary metastasis. One case presented with symptoms of cavernous sinus invasion and panhypopituitarism and the other case with diabetes insipidus. Both patients had a rapid progression of their disease despite chemotherapy and died after a few months. Pituitary metastases occur most commonly with breast cancer in women and lung cancer in men. The presence of polyuria and polydipsia in an oncologic patient should alert the physician for diabetes insipidus and, if confirmed, an imaging procedure of the pituitary gland is mandatory. Treatment for these tumors is often multimodal and includes surgery, radiation therapy, chemotherapy and hormone replacement. Although surgical series have not shown any significant survival benefits given by tumor resection, the patient's quality of life may be improved.
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PMID:[Two cases of pituitary metastases as initial presentation form of small cell lung cancer]. 2351 90

A 62-year-old male presented with stage IV lung adenocarcinoma with leptomeningeal metastases (LM). Gemcitabine (1000 mg/m2 i.v.) was administered on days 1 and 8 while oxaliplatin (100/m2 i.v.) was administered on day 1 and repeated for 4 cycles every 3 weeks. Computerized tomography (CT) and cerebrospinal fluid (CSF) were used to evaluate the response of the LM and the primary tumor to drug therapy. Following the administration of chemotherapy, headaches were observed to be notably reduced 6 days later and absent after 14 days. The symptoms of coughing and chest pain were alleviated. Subsequent to 4 cycles of treatment, the patient had a partial response (PR) and the CSF pressure was normal. Analysis of the CSF revealed that it was colorless, positive for protein, had a total cell number of 0/l and contained no cancer cells. However, the primary lung tumor progressed for 1 year. This may suggest that first-line therapies, including the use of gemcitabine and oxalipaltin, may be appropriate for the treatment of non-small cell lung carcinoma (NSCLC) with LM involvement.
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PMID:Gemcitabine plus oxaliplatin for the treatment of leptomeningeal metastases of non-small cell lung cancer: A case report and review of the literature. 2376 May 44

A 66-year-old man, chronic smoker, presented with episodes of syncope, hypotension and constitutional symptoms. Initial evaluation revealed pre-renal azotaemia and acute secondary adrenal insufficiency.MRI performed was interpreted as a pituitary macroadenoma with enlargement of the infundibulum (stalk). Further endocrinological tests performed suggested central hypothyroidism and hypogonadism. Subsequent development of haemoptysis, headache and diplopia warranted further investigations, which revealed stage IV small-cell lung carcinoma with adrenal metastases. Subsequent brain imaging showed lesions in the brain parenchyma, pituitary and stalk, characteristic of metastases. Thus, we present a very atypical case of pituitary metastases presenting with acute secondary adrenal insufficiency.
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PMID:Acute secondary adrenal insufficiency as the presenting manifestation of small-cell lung carcinoma. 2453 38


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