Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A rare case of malignant paraganglioma of the urinary bladder with metastasis to a lymph node in a 12-year-old girl is reported, and eight other previously recorded cases are reviewed. Headache, fainting, and hypertension initiated by voiding were the most prominent clinical symptoms. Hematuria was present in three cases and aided in prompt diagnosis. Cystography, pelvic angiography, and cystoscopy were most diagnostic. Segmental cystectomy when feasible, was the preferred surgical treatment. The prognosis was slightly better than for other forms of extraadrenal pheochromocytomas.
 ...
PMID:Malignant paraganglioma (pheochromocytoma) of the urinary bladder: report of a case and review of the literature. 45 May 24

A kindred with 2 current cases of pheochromocytoma is reported. The proband had classical features of adrenal medullary hyperfunction, in addition to Raynaud's phenomenon. After surgical removal of the right adrenal gland, containing a pheochromocytoma and a small paraganglioma, the patient was free of symptoms. The 12-year-old son of the proband was discovered to have relatively asymptomatic sustained hypertension on routine examination. Biochemical and radiological tests confirmed the diagnosis of a left adrenal pheochromocytoma, which was removed successfully.
 ...
PMID:Familial pheochromocytoma: a report of 2 cases in a kindred. 45 55

In a patient with paraganglioma, severe hypertension due to high levels of plasma norepinephrine was easily controlled with prazosin hydrochloride, 6 to 8 mg/day for 19 days before surgery. A prolonged antihypertensive response to the first two 1-mg doses suggested the presence of pheochromocytoma. This experience dramatizes the remarkable effectiveness of prazosin as a postsynaptic alpha-adrenergic receptor blocker and invites further trials of the drug for both the diagnosis and treatment of pheochromocytoma.
 ...
PMID:Prazosin in the diagnosis and treatment of pheochromocytoma. 71 11

A patient with a most unusual neoplasm of the bladder, a paraganglioma, is presented herein. A combination of episodes of hypertension during or immediately after micturition associated with hematuria is almost pathognomonic of this condition. The patient presented with hematuria only. Less than 7 per cent of all reported cases have a malignant course. The proper treatment appears to be partial cystectomy with wide margins of the affected area, being prepared for wide fluctuations in blood pressure in those patients who have elevated catecholamine levels preoperatively.
 ...
PMID:Paraganglioma of the bladder: report of a case. 111 94

We present a case report on a 35-year-old patient in whom a malignant sympathetic paraganglioma of the organ of Zuckerkandl was the cause of severe hypertension with excessive perspiration at night. Since curative surgery was not possible medical treatment was initiated. Interferon alfa 2b (Intron A, Essex Pharma) and the somatostatin-analogue SMS 201-995 (Sandostatin, Sandoz) had no effect on catecholamine production and progression of the tumor. Treatment with alpha-methyl-para-tyrosin (MPT, [Metyrosin], Demser, MSD) turned out to be an effective and well tolerable therapy in this patient with peritoneal carcinosis. Clinical and hormonal progression of the paraganglioma resumed only after two years of therapy, which constitutes the longest documented period of time of successful MPT treatment. The superior efficacy of MPT in our patient should encourage postoperative medical treatment with MPT in malignant pheochromocytoma or malignant paraganglioma, particularly when the tumor turns out to be resistent to alpha blocking drugs.
 ...
PMID:[Therapy of a malignant sympathetic paraganglioma of the organ of Zuckerkandl--a case report]. 166 29

Primary paraganglioma arises infrequently in the urinary bladder. We present the clinicopathologic, immunohistochemical, ultrastructural, and DNA flow cytometric findings in three cases (one man and two women). Ages at diagnosis were 19, 35, and 45 years. One female presented with paroxysmal headaches and hypertension that followed urination; the remaining two patients presented with hematuria. Immunohistochemical studies revealed positive reactivity for chromogranin (three patients), met-enkephalin (three), leu-enkephalin (three), vasoactive intestinal polypeptide (two), serotonin (one), and S-100 protein (one; sustentacular cells only). Neurosecretory granules were identified in all cases; in the patient with hypertension, the granules were small with eccentric cores similar to those of adrenal pheochromocytomas. A nondiploid DNA flow cytometric pattern was present in all three patients, an aneuploid pattern was present in two, and a tetraploid pattern was present in one. After diagnosis, one patient was alive without progression at 7 years, one died of an uncertain cause at 5 years, and one suffered multiple recurrences over a 24-year period before developing metastatic disease. While the presence of aneuploidy has been shown to be a predictor of malignant behavior in adrenal pheochromocytomas, our study illustrates that DNA ploidy cannot be used as a diagnostic criterion for malignancy in urinary bladder paraganglioma.
 ...
PMID:Paraganglioma of the urinary bladder: immunohistochemical, ultrastructural, and DNA flow cytometric studies. 174 2

The authors report the case of a 40 years old woman with a fronto parietal tumefaction and intracranial hypertension caused by a paraganglioma of the cranial vault. The clinical follow up is marked by rapid local recurrence of the tumor after complete excision. Usually paragangliomas arise in any area of the body where paraganglionar structures are situated (glomus jugulare, carotid glomus, vagus nerve). Other rare locations have been reported and remain difficult to be explained. The location at the cranial vault is exceptional. this tumor would probably arise from the paraganglionar cells which migrate from the neural crest following the trigeminal branches particularly the ophtalmic division.
 ...
PMID:[Paraganglioma of the cranial vault. Apropos of a case]. 175 67

During the past 20 years (1970-90), we had 24 patients with pheochromocytoma: 19 diagnosed clinically and 5 post-mortem. Their ages ranged from 17 to 74 (mean, 43.2 years). Males (n = 14) outnumbered females (n = 10), a 1.41:1 M:F ratio. A majority were symptomatic (95%), with a typical triad of headaches, palpitations and diaphoresis. Most frequent finding was hypertension (95%). It was sustained in 60% and paroxysmal in 35%. In 6 patients (25%) pheochromocytomas were bilateral, all familial. Fifteen were solitary adrenal tumors (63%); 3 (12.5%) were extra-adrenal: 2 intra-abdominal, and 1 cardiac paraganglioma of right atrium. Of 6 familial cases, 4 were associated to Von Hippel-Lindau (VHL) disease, while 2 were multiple endocrine neoplasia (MEN-II) patients. All familial cases were bilateral and in the adrenals. There were no malignancies. Among the 19 clinical cases pre-operative Dx was made by positive urine VMA or catecholamines urine levels: (95 and 100% sensitivity respectively). Preoperative visualization by CT or MRI was done in 62% of the most recent patients. In 5 earlier cases the diagnosis was made post mortem: 3 died of cerebral hemorrhage, 1 with a pons infarct and 1 with congestive heart failure (CHF). There were 2 post-operative deaths and another died 13 years later from thyroid medullary carcinoma. Of the 19 operated, 13 (68%) were cured. Thus pheochromocytomas retain considerable morbidity and some mortality. These rare tumors constitute a clinical diagnostic challenge yet a rewarding therapeutic experience for the alert physician.
 ...
PMID:Pheochromocytoma: a twenty year experience at the University Hospital. 177 16

A 47-year-old man had surgery for paraaortic paraganglioma in 1980 and 1985. In 1987, his urinary excretion of catecholamines and metabolites was extremely high. Scintigraphy with 131I-metaiodobenzylguanidine (MIBG) showed multiple bone and liver metastases. He was treated twice with infusions of 3.7 GBq of 131I-MIBG. After the first treatment, he had transient hypertension and pain in the back and right leg. Subsequent 131I-MIBG scintigraphy showed that the number of metastatic tumors had decreased. The second treatment was less effective. Excess catecholamines were treated with alpha-methyl-p-tyrosine (MPT), a catecholamine synthesis inhibitor, at doses between 250 and 2000 mg/day, which significantly decreased urinary NE excretion. This is the first case treated with 131I-MIBG in Japan.
 ...
PMID:A case of malignant pheochromocytoma treated with 131I-metaiodobenzylguanidine and alpha-methyl-p-tyrosine. 198 Mar 21

Paragangliomas of the retroperitoneum arise from specialized neural crest cells distributed along the aorta in association with the sympathetic chain. In order to ascertain characteristic CT features of extraadrenal retroperitoneal paragangliomas to differentiate them from other retroperitoneal tumors, 31 discrete tumors and two cases of paragangliomatosis in 28 patients were reviewed retrospectively, and the CT features were correlated with clinical and pathologic findings. There were 16 men and 12 women. Average age was 37 years (range, 11-70 years). Twenty-four patients (86%) had hypertension. Of these, catecholamine levels were elevated in all 18 patients who had biochemical studies. Four patients (14%) had malignant paragangliomas. The discrete tumors were classified by location as suprarenal (26%), renal hilar (32%), or infrarenal (42%). Suprarenal paragangliomas could not be distinguished from the ipsilateral adrenal gland on CT. The average size of functional tumors was smaller (7.0 cm) than that of nonfunctional tumors (12.0 cm), but the sizes of the two groups overlapped. Smaller tumors were more likely to be homogeneous and have well-defined margins than were larger tumors. Our findings indicate that extraadrenal retroperitoneal paragangliomas are functionally active more often than previously reported and that they are readily detected by CT as soft-tissue masses closely associated with the entire length of the abdominal aorta. However, no CT feature was found that was unique for paraganglioma.
 ...
PMID:Extraadrenal retroperitoneal paraganglioma: clinical, pathologic, and CT findings. 217 85


1 2 3 4 5 6 7 8 9 10 Next >>