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 long-term survival of a female patient with complicated diffuse metastatic leptomeningeal carcinomatosis (DMLC) secondary to lung cancer is reported. A 36-year-old woman, hospitalized with a chief complaint of headache and unproductive cough, was diagnosed as having primary lung adenocarcinoma (T4N1M1 oss) and was given systemic chemotherapy. Although progressive deterioration of her headache continued, repeated neurological examination, cerebrospinal fluid (CSF) examination, and cranial CT scans failed to show evidence of metastasis to the central nervous system, and the only finding suggesting CNS involvement was an elevated CEA level in CSF. Later in the course of her treatment, the patient suddenly lost her vision and subsequently consciousness due to acute increased intracranial pressure, and emergency ventricular drainage was performed for therapeutic and diagnostic purposes. Malignant cells were found in CSF obtained from a ventricular drainage and she was treated successfully by systemic and intrathecal chemotherapeutic agents. She was discharged after a ventriculoperitoneal shunt operation for hydrocephalus; a double-dome reservoir was used for continuous intrathecal administration of the anticancer drugs, and a shunt filter was located in the tube to prevent the dissemination of cancer cells. In addition to methotrexate and cytosine arabinoside, ACNU and interleukin-2 were administered intrathecally without serious adverse effects, but no apparent therapeutic effects were noted either. She survived over 2 years after DMLC was first diagnosed. At autopsy DMLC secondary to lung adenocarcinoma was confirmed, but no evidence of leukoencephalopathy due to aggressive intrathecal chemotherapy was found. Current therapy for patients with DMLC and its clinical problems are discussed in relation to our experience in this case.
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PMID:[A case of long-term survival of a patient with complicated diffuse metastatic leptomeningeal carcinomatosis secondary to lung adenocarcinoma]. 224 65

The neurotoxicity of local administration of nitrosoureas in malignant gliomas was investigated clinicopathologically. Twenty patients were entered into this study: 13 were treated with 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride (ACNU) and 7 with methyl 6-[3-(2-chloroethyl-3-nitrosoureido]-6-deoxy-alpha-D-glucopyranoside (MCNU). On the average, a single dose of 20 mg of ACNU was administered 15 times, for a total dose of 295 mg in each case, while a single dose of 11 mg of MCNU was given 2 times, for a total dose of 24 mg. These nitrosoureas provoked greater toxicity when the administration dose was larger or the indwelling multiperforated Silastic basket was in direct continuity with the ventricle or the basal cistern. Usually ACNU was well tolerated, whereas MCNU induced marked brain edema. Side effects consisted of headache, nuchal stiffness, vomiting, motor weakness, and cranial nerve palsy for ACNU, and headache, vomiting, abnormal respiration, and arrhythmia for MCNU. Pathological changes were represented by capsule formation, spongy degeneration and reactive gliosis of adjacent white matter, occlusion of neighboring arteries, and demyelination of cranial nerves in the patients treated with ACNU, while they were represented by focal brain necrosis in two patients treated with MCNU. The differences in neurotoxity of ACNU and MCNU conceivably derive from the different blood-brain delivery of these drugs.
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PMID:Neurotoxicity of local administration of two nitrosoureas in malignant gliomas. 235 97

A case of pineocytoma associated with intraventricular and meningeal metastasis is reported. The patient, a 25-year-old female, was admitted complaining of headache. Computed tomography revealed an irregular-shaped pineal lesion enhanced by contrast medium and accompanied by a cyst. An intraventricular cystic metastatic lesion and meningeal metastasis were also suggested. Biopsy of the pineal region proved the lesion to be a pineocytoma without neuronal or glial differentiation. Ventriculoperitoneal shunting was performed, and radiation therapy combined with chemotherapy (ACNU and vincristine) was administered. This treatment apparently destroyed both the primary and metastatic lesions, and the patient returned to her normal life. In 4 years of follow-up there has been no recurrence of the tumor. Pineocytoma with meningeal metastasis usually has a poor prognosis, but in this case combined radiation therapy and chemotherapy was curative. Although pineocytoma is rarely accompanied by a cyst, in cases of a pineal lesion coexistent with a cyst, a diagnosis of pineocytoma should be considered.
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PMID:[Cystic pineocytoma successfully treated with synchronized chemoradiotherapy. Case report]. 247 17

A case of malignant astrocytoma following radiotherapy for pituitary adenoma is presented in detail with a review of the literature. A 38 year-old housewife had developed a growth-hormone secreting pituitary adenoma, and received a total of 50 Gy at the pituitary region. Four years and six months later, she began suffering headache and vomiting. Computed tomography showed an extensive low density with ring enhancement in the right temporal region, corresponding to the previously irradiated field. A right frontotemporoparietal craniotomy was carried out, and a soft and reddish tumor was partially removed. The histological diagnosis was that of malignant astrocytoma. The patient was submitted to postoperative radiochemotherapy, receiving a total of 60 Gy, nimustine hydrochloride (ACNU), and tegafur (FT). Subsequently, after three months of clinical relief, she developed tumor regrowth, and died four months later. The present case fulfills the criteria for radiation-induced tumor established by Cahan et al.: A tumor location within irradiated area, no evidence of tumor prior to radiotherapy, a long latency period between radiation and tumor occurrence, and histological verification of the tumor. Thirty-nine cases of radiation-induced gliomas including the present case have been reported in the literature. It is noteworthy that the majority occur in the younger age bracket. Male preponderance is noted as it is in primary cerebral gliomas. The primary lesions for radiation frequently include leukemia and lymphoma. Craniopharyngioma, pituitary adenoma, and medulloblastoma etc are also included.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Malignant astrocytoma following radiotherapy in pituitary adenoma: case report]. 268 39

The authors reported the clinical course and the postmortem examination of a unique case of neurocutaneous melanosis with numerous anomalies and complications, which included congenital dislocation of lenses, hypogonadism, ectopia of prostatic duct, genuine phimose, retentio testis, psina bifida and neurogenic bladder. This 13-year-old boy with a large hairy nevus in a bathing trunk configulation and multiple small nevi over the whole body since his birth was admitted to our hospital for evaluation of headache and vomiting. Neurological examination showed bilateral papilledema and slight left hemiparesis. A CT scan revealed a large right frontal mass and craniotomy was performed with subtotal removal of this tumor which was confirmed as a malignant leptomeningeal melanoma. He initially made uneventful postoperative recovery, and two courses of chemotherapy with DTIC, ACNU and VCR were given; however, the currence of brain tumor ensued shortly thereafter, and he died in approximately six months after the onset of intracranial symptoms despite of the third course of chemotherapy. Thirty five cases of neurocutaneous melanosis associated with or without malignant melanoma have been reported in Japan. Twenty-eight cases were male and 7 female. Two cases showed the evidence of primary malignant melanoma outside of the central nervous system, whereas twenty eight leptomeningeal melanoma, in which 22 were solid and 6 diffuse, were shown intracranially. Other 5 cases had epileptic seizure and/or hydrocephalus caused by wide spreaded leptmeningeal melanosis. This high incidence of intracranial malignant melanoma in this disorder was remarkable compaired with the previous reports in other countries. Mean duration between deaths and the onset of symptoms of intracranial hypertension or focal neurological signs was 7 months, ranging from 1 to 24 months, showing the rapidly deteriorating course in this disorder.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[An autopsy case of neurocutaneous melanosis associated with intracerebral malignant melanoma]. 332 33

Two cases of postoperative brain metastasis of breast cancer were evaluated after chemotherapy using ACNU. Case 1: A 47-year-old female, who had undergone right standard radical mastectomy in 1979 for breast cancer (T2 N0M0, papillo-tubular carcinoma), was treated with ADM, TAM, and 60Co irradiation for bone metastasis in 1983. In 1984, she complained of loss of consciousness and paralysis of the extremities due to brain metastasis. After chemotherapy using ACNU (100 mg X 3), brain metastasis could not be detected on CT. She remained asymptomatic for more than 9 months without recurrence after therapy. Case 2: A 46-year-old-female, who had undergone left standard radical mastectomy in 1980 for breast cancer (T1 N1 M0, medullar tubular carcinoma), complained of headache and vertigo accompanying a hard tumor in the scalp. Chest X-ray and CT demonstrated right lung metastasis and left cerebellar metastasis. After combination chemotherapy using ACNU (100 mg) + MMC (4 mg) i.v. and FT (600 mg/day) p.o., symptoms and tumor on CT disappeared for 10 months after therapy. However, the patient died of aggravation of angina pectoris and D.M. from which she had been suffering for several years previously. These two cases correspond to complete response (CR) according to the response criteria proposed by Koyama-Saitoh.
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PMID:[Successful chemotherapy in postoperative brain metastasis of breast cancer using ACNU--two case reports]. 345 52

A report on a rare case of pineocytoma is presented. A 27-year-old woman visited our clinic because of a 3-month history of intermittent headaches and nausea. A CT scan revealed the presence of a marked obstructive hydrocephalus and mass without any contrast enhancement in the pineal region. Immediately, V-P shunting was performed and resulted in relief of all symptoms. Ventriculography showed a complete occlusion at the aqueductus Sylvii and filling defect at the posterior part of the 3rd ventricle. The patient was operated on in the prone position via infratentorial supracerebellar approach by suboccipital craniectomy on November 9, 1982. A grayish red-colored, well-defined solid tumor located at the pineal region was removed partially. The histopathological appearance of this tumor resembled the pattern of the normal pineal gland. Many cells exhibited a polar form, eosinophilic cytoplasm with the process often being directed toward a blood vessel. The cells around the central areas occupied by pale eosinophilic material were arranged like a "rosette". Combined chemo-radiotherapy was carried out after surgery. That is, a total dose of 4,825 rads to the whole brain was irradiated, and ACNU 140 mg and VCR 6 mg in total were administered intravenously and intermittently. After irradiation therapy, the tumor increased in size producing a ring-like enhancement effect as shown on repeated CT scans. During this time, she started to complain of blurred vision with Parinaud's sign. A second operation via interhemispheric approach by right parietal craniotomy was undergone, and the tumor was partially resected again on March 29, 1983.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pineocytoma--a case report]. 370 49

A case of malignant lymphoma in the skull after head injury associated with whole bone metastasis is reported. The patient was a 66-year-old man who was admitted to Almeida Memorial Hospital because of headache and general fatigue 2 months after head injury. After admission tumors appear in the frontal and occipital region and grew rapidly. Plain craniogram revealed large map-like bone destructions and multiple punched out lesions. Bone scintigram with 99mTc-MDP revealed multiple accumulations of RI in the skull, vertebrae, ribs and pelvis. CT scan revealed destructive, markedly enhancing bone tumor which was compressing the brain as an extradural mass in the left frontal and occipital regions. Pathological examination of the tumor revealed malignant lymphoma of non-Hodgkin type and diffuse pleomorphic type. Though combination chemotherapy with ACNU, FT 207, PSK, CHOP (Cyclophosphamide, Adriamycin, Vincristine and Predonisone) and Acracinomycin A was performed after operation, and brought forth regression of tumor size and improvement of clinical symptoms transiently, he died 6 months after the onset because of recurrence in many bones with pathological fracture and complications such as pneumonia, DIC and acute renal failure. At autopsy the tumors were found to be localized only in the bones, but in none of lymphnode or visceral organs. Malignant lymphoma appearing initially as a skull tumor is rare, and its diagnosis and treatment were discussed.
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PMID:[A case of malignant lymphoma in the skull after head injury associated with multiple bone tumors]. 408 41

A case of primary intracranial yolk sac tumor, the first known case growing in the frontal lobe, is compared with similar cases of suprasellar region. The case, 18-year-old female, suffered from headache, vomiting and visual disturbance for one month prior to the hospitalization. Plain CT scan demonstrated suppressed left anterior horn and normal density area in front of it. After injection of contrast medium, the area was enhanced distinctly. The left carotid angiography displayed a hypervascular mass in the suprasellar region and tumor stain was also seen in the capillary phase. Bilateral frontal craniectomy was performed and the tumor was almost totally removed macroscopically. The tumor situated in the left frontal lobe infiltrated into the optic nerve and a part of anterior cerebral artery. Histologically the tumor was diagnosed as yolk sac tumor according to Teilum's classification. There were stellate cells arranged in loose vacuolated network which formed cystic cavities and a complicated network of honeycomb with communicating cavities and extracellular PAS-positive hyaline globules. Glomerular-like structures (Schiller-Duval body) was also seen. Immunoperoxidase study clearly demonstrated the presence of intracytoplasmic alphafetoprotein granules in the tumor tissue. In radioimmunoassay, the level of the serum alphafetoprotein measured was two folds higher than that of the normal range, postoperatively. Although irradiation (local 3000 rads, whole 3000 rads) combined with chemotherapy (ACNU, Futraful), PSK had almost no effect. The effect of other chemotherapy (Cis-platin, VBL, Bleomycin) was indicated by the diminish size of the tumor. Five months after the onset, she was discharged with almost no neurological findings other than left visual loss. Pathological findings and clinical treatments were also discussed in detail.
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PMID:[Primary intracranial yolk sac tumor developing in the frontal lobe from the inside of the sphenoidal ridge]. 646 49

Primary malignant melanoma of the cerebral nervous system is an uncommon entity. A case of primary intracranial melanoma associated with dermoid cyst is reported. The patient was a 40-year-old man who was admitted to our hospital on May 2, 1979 complaining of headache, double vision, left hemiparesis and Jacksonian seizure. On admission he had a slight degree of papilledema. Left abdominal reflex was absent. Lumbar puncture showed high pressure of the cerebrospinal fluid which was otherwise normal. Plain skull films showed a calcification in the pineal region. CT scan demonstrated multiple high density areas with slight enhancement after contrast medium infusion in the right fronto-parietal region and a well defined high density area associated with an irregular low density area without contrast enhancement in the right pulvinar and the atrium and temporal horn of the right lateral ventricle. However, no tumor stain was seen on angiograms. On May 8, 1979 partial removal of the tumor was performed. Areas of black discoloration were seen in the leptomeninges of the right fronto-parietal lobes. Histopathological examination of this tumor revealed primary intracranial melanoma. Postoperatively DTIC, ACNU and Vincristine were administered intravenously but the tumor showed only little sensitivity. He died 5 months after operation. Autopsy was performed on October 8, 1979. Malignant melanoma in the right fronto-parietal lobes was invading the cerebellar hemisphere and spinal cord, but any tumor was not found in any other parts of the body except for this central nervous system. The tumor in the right pulvinar extending to the atrium and temporal horn of the right lateral ventricle was a dermoid cyst with calcification histopathologically. A case of primary intracranial melanoma associated with dermoid cyst has not been reported in any other associated with dermoid cyst has not been reported in any other literature yet.
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PMID:[An autopsy case of primary intracranial melanoma associated with dermoid cyst (author's transl)]. 709 73


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