Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The toxic effects and tissue uptake of both cisplatin and oxaliplatin--[(1R, 2R)-1,2-cyclohexanediamine-N,N'] [oxalato(2-)-O,O']platinum--were previously shown to vary similarly according to dosing time in mice. A 4-hour infusion of cisplatin resulted in fewer side effects and allowed administration of higher doses at 16 hours than at 4 hours in patients with cancer. We hypothesized that the continuous venous infusion of oxaliplatin for 5 days would be less toxic and would deliver a higher dose to the patient if the drug were infused at a circadian rhythm-modulated rate (peak at 16 hr; schedule B) rather than at a constant rate (schedule A). We tested this hypothesis in a randomized phase I trial. We escalated the dose of oxaliplatin to the patient by 25 mg/m2 per course. Courses were repeated every 3 weeks. An external, multichannel, programmable-in-time pump was used for the infusions. Toxicity was assessable for 94 courses in 23 patients (12 patients with breast carcinoma, nine with hepatocellular carcinoma, and two with cholangiocarcinoma). The incidence of neutropenia of World Health Organization grades II-IV and the incidence of distal paresthesias were 10 or more times higher (P less than .05) with schedule A than with schedule B. In addition, vomiting was 55% higher (P = .15) with schedule A than with schedule B. Furthermore, with schedule B, the mean dose of oxaliplatin (P less than .001) and its maximum tolerated dose (P = .06) could be increased by 15% over those doses with schedule A. An objective response was achieved in two of the 12 patients with previously treated breast cancer. We recommend that the dose of oxaliplatin for phase II trials be 175 mg/m2, delivered according to the circadian rhythm-modulated rate.
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PMID:Phase I trial of 5-day continuous venous infusion of oxaliplatin at circadian rhythm-modulated rate compared with constant rate. 234 69

Clinical and pathological analysis of 66 cases of fibromatoses are presented. The age range in our series was 1 to 72 years. Superficial fibromatoses occurred predominantly in older patients with a peak incidence in the fifties while deep fibromatoses occurred predominantly in younger patients with a peak incidence in the twenties. Male to female ratio was 1.4 to 1. The abdominal fibromatosis occurred in female while our palmar fibromatosis occurred in male. There were 17 cases (26%) of multiple fibromatoses which occurred most frequently on both palms and had a tendency to symmetric distribution. The latent period between the two fibromatoses in a patient ranged from 1 year to 36 years. Clinical presentations included a palpable nodule or mass; flexure contracture of finger; penile hypertrophy, contracture, or discomfort on erection; and soreness, tenderness, or paresthesia over the tumor. Hydronephrosis may be complicated by intraabdominal fibromatosis. Size of the tumors ranged from 0.5 cm. To 30.0 cm. Three cases were associated with diabetes mellitus, 2 with alcoholics, 1 with liver cirrhosis, 2 with pulmonary tuberculosis, and 3 with hepatocellular carcinoma, cholangiocarcinoma, and mammary papillary carcinoma, respectively. Nine cases (14%) were associated with variable types of trauma, including being hurt by a stick, intramuscular injection in the gluteal region, tying penile shaft with a plastic band, breast massage and hot applying, and operation on abdomen. The superficial fibromatoses seldom recurred after excisional biopsy or fasciectomy while the deep fibromatoses often recurred. The recurrent rate of the deep fibromatoses was 21%. Malignant transformation or spontaneous regression was not found.
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PMID:[The fibromatoses. A clinicopathological study of 66 cases]. 281 66

A primary hepatocellular carcinoma associated with underlying hemochromatosis appeared as a metastatic mandibular lesion. A swelling of the retromolar area and mandibular paresthesia were the presenting complaints. Hepatocellular carcinoma rarely metastasizes to the orofacial area. To our knowledge, only 18 cases have been reported. The clinical, radiographic, and histologic features of an additional case of hepatocellular carcinoma metastatic to the left posterior alveolar ridge is reported, and the literature is reviewed.
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PMID:Hepatocellular carcinoma presenting as an oral cavity lesion. 284 39

Hepatocellular carcinoma metastatic to the oral cavity is a rare phenomenon. From 1957 to date, 51 case have been documented in the English literature. In this report we describe a case of metastatic hepatocellular carcinoma manifesting itself as unilateral mandibular paresthesia before the discovery of the primary tumor. In addition, we review the literature related to metastatic hepatocellular carcinoma and the pathways of metastasis.
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PMID:Initial presentation of hepatocellular carcinoma as a mandibular mass: case report and review of the literature. 979 31

Hepatocellular carcinoma (HCC) is relatively uncommon in the United States, although hepatitis C, one of the known risk factors for disease, is currently showing burgeoning growth in the country. Hence, it is possible that the incidence of HCC also will increase. Clinicians and pathologists in the United States are relatively unfamiliar with the patterns of metastatic spread for HCC. We report 2 US-native patients with cirrhosis and HCC who developed epidural space metastasis, a pattern of disease spread seen infrequently, even in endemic areas. Diagnostic testing was delayed in both patients because of the lowered suspicion for metastasis and the fact that neither patient had recognized metastatic spread to more common sites, such as lung or lymph nodes. New-onset neck or back pain-especially with symptoms of paresthesia, radiculopathy, or cord compression-in the setting of HCC warrants prompt investigation for metastases to the spine and epidural space.
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PMID:Hepatocellular carcinoma metastases to the epidural space. 2052 57

Transcatheter arterial chemoembolization (TACE) has been used widely to treat patients with unresectable hepatocellular carcinoma. However, this method can induce various adverse events caused by necrosis of the tumor itself or damage to nontumor tissues. In particular, neurologic side effects such as cerebral infarction and paraplegia, although rare, may cause severe sequelae and permanent disability. Detailed information regarding the treatment process and prognosis associated with this procedure is not yet available. We experienced a case of paraplegia that occurred after conducting TACE through the intercostal artery to treat hepatocellular carcinoma that had metastasized to the rib. In this case, TACE was attempted to relieve severe bone pain, which had persisted even after palliative radiotherapy. A sudden impairment of sensory and motor functions after TACE developed in the trunk below the level of the sternum and in both lower extremities. The patient subsequently received steroid pulse therapy along with supportive care and continuous rehabilitation. At the time of discharge the patient had recovered sufficiently to enable him to walk by himself, although some paresthesia and spasticity remained.
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PMID:Spinal cord injury after conducting transcatheter arterial chemoembolization for costal metastasis of hepatocellular carcinoma. 2309 13

Tyrosinemia type I is an autosomal recessively inherited metabolic disease of tyrosine metabolism due to the deficiency of fumarylacetoacetate hydrolase. Clinical manifestations include hepatic failure, cirrhosis, hepatocellular carcinoma, renal fanconi syndrome, and neurologic crisis. With the introduction of 2-(2-nitro-4-trifluoro-methylbenzyol)-1,3 cyclohexanedione treatment the prognosis improved with reduced rate of complications. "Neurologic crisis" of tyrosinemia type I is a rare complication seen after discontinuation of treatment characterized with anorexia, vomiting, and hyponatremia in the initial phase continuing with paresthesia and paralysis of the extremities and the diaphragm. Here, we report a tyrosinemia type I patient who admitted to the hospital with nonspecific symptoms such as vomiting, anorexia, weakness, and restlessness only after one month discontinuation of nitisone and diagnosed as neurological crisis.
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PMID:Tyrosinemia type 1 and irreversible neurologic crisis after one month discontinuation of nitisone. 2718 89

An incidental liver mass was discovered in a 65-year-old male during a routine ultrasound (US) check-up of his hiatal hernia. The mass, which showed no malignant characteristics, was interpreted as a focal nodular hyperplasia (FNH). Due to normal blood tests and tumor marker levels, as well as the patient's asymptomatic presentation, only regular monitoring was performed. At a check-up 18 months later, CT examination indicated hepatocellular carcinoma (HCC). Surgery was no longer possible due to diffuse liver involvement. Transarterial chemoembolization (TACE) and chemotherapy were started. A possible metastasis to the right adrenal gland was detected. The patient started to experience headaches, vertigo, paresthesia, and pain of the right jaw. A CT scan of the head showed a mass in the right masticatory space. A CT-guided biopsy confirmed a HCC metastasis.
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PMID:Unusual Presentation of Hepatocellular Carcinoma and Rare Metastasis to the Masticatory Space. 3172 49