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 15-year-old male was admitted because of diplopia and persistent headache. Postcontrast computed tomography (CT) revealed a homogeneously enhanced large mass, 3 x 4 cm in size, in the pineal region and moderate obstructive hydrocephalus. A right ventriculoperitoneal shunt was installed. At that time, the serum alpha-fetoprotein (AFP) level increased to 23,036 ng/ml, but the level of serum beta-subunit of human chorionic gonadotropin was less than 0.2 ng/ml. These data indicated the tumor to be a pure yolk sac tumor. Following cisplatin-vinblastine-bleomycin (PVB) therapy and whole-brain irradiation (50 Gy), the tumor disappeared on CT, although the AFP level did not return to normal. Eight months after the completion of initial therapy, he had lumbago. Spinal magnetic resonance imaging revealed a metastatic mass at the L5-S2 levels, which was subtotally removed and histologically diagnosed as yolk sac tumor. Postoperative local irradiation (30 Gy) was performed. Seven months after the operation, spinal dissemination at the Th7 level occurred and, 1 month later, intracranial dissemination in the left cerebellopontine angle was detected. He died 25 months after the first admission. PVB therapy did not prevent spinal dissemination in this case.
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PMID:Intracranial and intraspinal dissemination from pineal yolk sac tumor treated by PVB therapy--case report. 170 59

An 18-year-old male was admitted with headache, nausea, and vomiting. Computed tomography (CT) revealed an enhanced tumor of the pineal region and hydrocephalus. The tumor was partially resected via a parieto-occipital craniectomy. The histological diagnosis was germinoma. No serum tumor markers such as alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) were detectable. A ventriculo-peritoneal (V-P) shunt was emplaced and radiation therapy (whole brain 59 Gy) given. The tumor and the hydrocephalus regressed completely and he returned to work. Six years later, he experienced constipation and general fatigue. CT and echotomography of the abdomen showed a large peritoneal tumor and ascites. Laboratory investigation demonstrated serum levels of AFP 7640 ng/ml and HCG 150 IU/l, and high ascitic levels of AFP 12,890 ng/ml and HCG 1030 IU/l. AFP and HCG levels regressed after combined chemotherapy. However, he died due to leukopenia and pneumonia. Autopsy found no metastasis of tumor cells to the central nervous system. The peritoneal cavity contained hemorrhagic fluid and a large tumor 4100 g in weight. The tip of the V-P shunt tube was in front of the tumor. No neoplasm was found in the testis, retroperitoneal cavity, thymus, and other organs. The microscopic appearance of the peritoneal tumor was different to the first pineal tumor. The neoplasm was confirmed as a mixed germ cell tumor with teratoma components and suspected to be a metastasis of the pineal tumor through the V-P shunt system.
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PMID:[Abdominal metastasis of a pineal region tumor through ventriculoperitoneal shunt. Case report]. 172 35

The antitumoral effect of gamma-Interferon (Re-IFN-gamma, KW-2202) on nine patients with hepatocellular carcinoma (HCC) has been investigated. gamma-IFN was administered intravenously biweekly at a dose of 8-24 x 10(6) units/day for 5 consecutive days. As all patients had measurable disease determined by an abdominal CT, the antitumoral effect was evaluated by CT, according to the criteria of Koyama and Saito, During gamma-IFN therapy, one patient, who received a total of 4.4 x 10(8) units of gamma-IFN, achieved a partial response (PR) 133 days after onset of treatment. Another patient showed a minor response (MR) 43 days after start of therapy. The duration of the PR and MR were 7.8 weeks and 10.8 weeks, respectively. Two patients were assessed as having had no change (NC), and 5 patients as still manifesting a progressive disease (PD). Marked falls in serum alpha-fetoprotein levels during therapy were observed in 2 cases of which one was graded as having obtained a PR, and the other, a NC. The toxicities observed were fever, general malaise, headaches, and joint pains, which were slight and transient in most cases. In one case, however, a therapy was stopped because of a continuous and severe shoulder pain with no metastasis. Further studies on the use of IFN, possibly in combination with other chemotherapeutic agents, should be performed in patients with HCC.
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PMID:[Antitumoral effect of gamma-interferon in patients with hepatocellular carcinoma]. 245 29

A case, a 18-year-old male, of an endodermal sinus tumor (yolk sac tumor) in the fourth ventricle, was reported. The patient had a month history of headache, vomiting and gait disturbance prior to the hospitalization, when he admitted to our service he was in lethargic condition with left cerebellar ataxia and horizontal nystagmus. Lumbar tap revealed clear CSF under normal pressure of 110 mm H2O with the CSF protein of 432.5 mg/dl and cell count of 147/3. The vertebral angiography demonstrated space occupying lesion in the posterior fossa. Plain CT demonstrated only disappearance of the fourth ventricle and slightly dilated bilateral ventricles and third ventricle. However diffuse high density area around the fourth ventricle was demonstrated and the wall of bilateral anterior horn was slightly enhanced, after injection of contrast media. There was no other abnormal findings around the pineal region. Suboccipital craniectomy was performed and the tumor was totally removed macroscopically. The tumor was situated in th floor of the fourth ventricle and infiltrated into the fourth ventricular wall and th adjacent cerebellar tissue. The tumor was with soft, greyish color and extremely vascular. Histologically the tumor was diagnosed as endodermal sinus tumor according to Teilum's classification. There were stellate cells arranged in a loose with vacuolated network which formed cystic cavities and a complicated network of honeycomb appearance with a system of communicating cavities and channels. Various size of intra- and extracellular PAS-positive hyaline globules were also seen. Glomerular-like structure (Schiller-Duval body) was not observed. Immunoperoxidase study clearly demonstrated the presence of intra- and extracytoplasmic alpha-fetoprotein granules in the tumor tissue. The amount of the serum alpha-fetoprotein, measured by radioimmunoassay, showed 400 ng/ml. After irradiation in the posterior fossa (5000 rad) the patient was discharged. Three months later, follow up CT demonstrated small high density area in the anterior horn of the left lateral ventricle, so he was rehospitalised. Irradiation in the whole brain was again administered. The tumor was very radiosensitive. CT, after 800 rad, demonstrated complete disappearance of the tumor. After irradiation totally (3000 rad), he discharged with left cerebellar ataxia.
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PMID:[Primary endodermal sinus tumor of the fourth ventricle (author's transl)]. 616 17

A 7-year-old boy was admitted to Hokkaido University Hospital complaining of headache and vomiting. On admission he was slightly confused and presented Parinaud's sign. CT scan revealed abnormal high density mass with contrast enhancement effect at the pineal region and obstructive hydrocephalus. Laboratory studies showed the normal value of human chorionic gonadotropin and no trace of alpha-fetoprotein. Germinoma was most suspected based on the findings of CT scan and laboratory studies. The radiation therapy was carried out for a month and CT scan taken after the radiation therapy revealed marked reduction of the size of the tumor at the pineal region, and he was discharged. But he was re-admitted 3 months after the discharge complaining of headache and vomitting again. CT scan showed the recurrence of the tumor and laboratory studies showed abnormal high value of A.F.P. After the ventriculo-peritoneal shunt, the sub-occipital craniectomy was performed by the Stein's approach, and the tumor was removed. Pathologically the tumor was a typical yolk sac tumor. This case is a very interesting case because it suggests an alternation of the element of the germ cell tumor by the radiation therapy. At first admission, germinoma was the main element of the tumor judging from the effectiveness of the radiation therapy and laboratory studies. But the main element of the tumor seemed to have changed to yolk sac tumor after the radiation therapy. The relation between the tumor markers and the types of the germ cell tumor and histopathological characters of the intracranial germ cell tumor were discussed.
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PMID:[Primary intracranial germ cell tumor with abnormal high value of alpha-fetoprotein after the radiation therapy]. 618 90

Twenty four women with severe pre-eclampsia diagnosed before 34 weeks' gestation were compared with 48 randomly selected controls matched for age and parity. Subjects were studied in the puerperium using a questionnaire, clinical examination, and review of case records. A history of infertility, headaches (particularly migraine), pre-eclampsia in a previous pregnancy, or a raised serum alpha-fetoprotein concentration at the time of screening for neural tube defect in the index pregnancy were all identified as significant risk factors in the pre-eclamptic women. Maternal age, a history of chronic hypertension or renal disease, or excessive maternal weight were not significantly associated with pre-eclampsia. Almost all the infants of pre-eclamptic women showed retarded growth: 18 were below the 10th centile and only one weighed more than the 25th centile. Four babies died. These observations indicate that pre-eclampsia of early onset may differ from the late onset disease not only in its very high perinatal morbidity and mortality but in its distinctive maternal risk factors.
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PMID:Case-control study of severe pre-eclampsia of early onset. 641 Dec 32

This is the first reported case of magnetic resonance imaging (MRI) findings of cranial metastasis from hepatocellular carcinoma. A 53-year-old male was admitted to our hospital on August 23, 1994, complaining of severe headache and a subcutaneous mass on the forehead. He was diagnosed as hepatocellular carcinoma in February, 1994, at another hospital. Because of multiple intrahepatic metastasis, he was inoperable and received transarterial embolization (TAE) on February 15, 1994. He had noticed the subcutaneous mass two months prior to admission, and its recent rapid growth, and morning headache. On admission, there was no abnormality observed by neurological and physical examination except the subcutaneous mass on his forehead, 5 x 7 cm in size. It was elastic soft and unmovable, and he felt tenderness. Laboratory examination showed only mild liver dysfunction. HBsAg was negative, and alpha-fetoprotein and PIVKA-II (Protein Induced by Vitamin K Antagonists) were within normal limit. Skull X-ray showed a round bone defect in the frontal bone. Computerized tomographic (CT) scan showed bone destruction and a well-circumscribed high density mass extending from the frontal subcutaneous region into the cranial cavity. MRI showed the tumor compressing the left frontal lobe on T1 weighted image as isointense and T2 weighted image showed a slight low intense mass. The tumor was clearly enhanced on both CT scan and MRI. Left external carotid angiogram demonstrated that the hypervascular tumor mainly fed by a frontal branch of the left superficial temporal artery in the frontal region. Tumor and bone scintigram revealed multiple bone metastasis. Lung CT scan showed no metastasis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A rare case of cranial metastasis from hepatocellular carcinoma]. 747 23

Germ cell tumors originating in the posterior fossa are very rare. Described herein is a case of primary germ cell tumor (yolk sac tumor) found in the cerebellar vermis. A 5-year-old boy who complained of headache was admitted. CT and MRI revealed a tumor with diffuse enhancement by contrast medium in the right cerebellar vermis. Total removal was performed and a diagnosis of medulloblastoma or ependymoma was suspected. However, the tumor proved to be a yolk sac tumor with embryonal carcinomatous components from histological findings. Abnormally high levels of alpha-fetoprotein were found in blood and cerebrospinal fluid. Extensive examination indicated that the intracranial lesion had not metastasized from a primary extracranial tumor.
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PMID:Cerebellar primary germ-cell tumor in a young boy. 789 60

Cases of embryonal carcinoma arising in the basal ganglia are rarely reported. According to the literature available, only 5 cases of embryonal carcinoma, arising from the basal ganglia, have been reported to date. This paper reports one such case we recently encountered. The patient was a 15-year-old boy. He was first admitted to another hospital because of occasional headache and vomiting. During the hospital stay, CT scans revealed abnormalities. For this reason, the patient was referred to our critical care center. Upon admission to our center, a physical examination revealed no abnormalities, but neurological examination disclosed left hemiparesis. CT scans revealed a large mass lesion of a low to high density in the right basal ganglia, accompanied by midline shift and ventricular dilatation. Elevation of human chorionic gonadotrophin (HCG) and alpha-fetoprotein (AFP) in both serum and cerebrospinal fluid (CSF) was observed. The tumor with multiple cysts was removed totally by craniotomy. The removed tissue was rated histopathologically as mixed-type germ cell tumor composed of germinoma and embryonal carcinoma. The removed tumor cells were found immunohistologically to contain HCG and AFP. Postoperative CT scans showed complete disappearance of the tumor. Taking into account a recent report that a combined cisplatin and etoposide therapy (PE chemotherapy) was effective in treating intracranial germ cell tumors, we used this chemotherapy for postoperative management of this patient. The patient underwent 3 cycles of PE chemotherapy during the 3 months after surgery. The elevated HCG and AFP levels in serum and CSF returned to their normal range within 2 months after surgery. CT and tumor markers revealed no signs of recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cisplatin-etoposide chemotherapy of an embryonal carcinoma arising in the basal ganglia of the cerebrum: a case report]. 807 94

Intracranial mixed germ-cell tumors are rare. We describe the findings from six autopsies of patients with these tumors. The patients were all young at presentation (mean age, 16 years), and five of the six were male. Headache, vomiting, polyuria and diplopia were common symptoms. Radiographic evaluation demonstrated a mass on the midline of the brain. The patients were treated mainly with radiation, but survival (mean, 3.7 years) was not as long as predicted. At autopsy, the tumors occupied most of the ventricular spaces, and ranged from being well-circumscribed to invasive. All tumors contained both germinoma components and nongerminomatous germ-cell tumor components. Because the distribution of these components was not homogenous, at least two sections were necessary for the diagnosis. Immunoreactivity for placental alkaline phosphatase was found in all tumors. Immunostaining for human chorional gonadotropin, alpha-fetoprotein and carcinoembryonic antigen was usually associated with abnormally high serum levels of these tumors markers in life. A number of the cells in both kinds of tumor components expressed proliferating cell nuclear antigen, probably reflecting the intense malignant potential.
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PMID:Mixed germ-cell tumor of the brain. Pathologic study of six autopsy cases. 885 48


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