Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Association of monoclonal gammopathies of undetermined significance with primary hyperparathyroidism has been reported by several investigators. We reviewed the records of our cases of surgically proven parathyroid adenoma with serum protein electrophoresis within 6 months preceding parathyroidectomy. Among 911 patients who had hyperparathyroidism and were more than 50 years old, immunoelectrophoresis revealed a monoclonal gammopathy of undetermined significance in nine (1.0%). This incidence is similar to those in two studies of a normal population (1.25% and 1.6%). In our nine patients, the monoclonal proteins ranged from 1.0 to 1.9 g/dl. The monoclonal protein was unchanged during follow-up (median 62 months) in eight and increased in one (who probably has evolving multiple myeloma). Nine of the 911 patients with hyperparathyroidism had a malignancy, and this also is similar to previously reported experience.
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PMID:Primary hyperparathyroidism and monoclonal gammopathy of undetermined significance. 708 Nov 54

Using a bacterial fusion protein, a deleted colorectal carcinoma (DCC)-specific monoclonal antibody (MAb) 127-22 was established. Although MAb 127-22 reacted with almost all normal tissues, it did not react or only weakly reacted with many cancer cell lines, including colonic cancer lines, in flow cytometry. In Western immunoblots, the MAb reacted with a single 190-kDa molecule in a myeloma line Ara-10 extract. This component was scarcely detected in colonic cancer cell lines. Immunoblots of samples from 25 pairs of colonic cancers and adjacent normal tissues and from five adenoma tissues revealed that all normal colonic and adenoma tissues significantly expressed the DCC protein, whereas colonic cancer tissues showed poor expression. These results indicate not only deletion of and lowered mRNA expression of the DCC gene, but also marked reduction of DCC protein occurred in colonic cancer tissues. In addition, colonic cancer patients with liver metastasis expressed significantly lower levels of DCC than those without, suggesting the prognostic value of DCC expression.
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PMID:Reduced expression of deleted colorectal carcinoma (DCC) protein in established colon cancers. 947 45

From 1990 to 1996, 21 patients with sacral tumor were surgically, including 8 cases with giant tumor of bone, 7 cases of spinal cord tumor, each 2 cases of neurofibroma and adenoma, 1 case of myeloma and 1 case of lipoma with low grade of malignancy. A total of 22 operations involving one for recurrent tumors in 21 cases were performed. Sacral resection and curettage plus resection were the surgical ways. 19 patients were followed up with an average period of 2.5 years. 15 patients showed good results, 3 patients occurred urinary incontinence and constipation, one of 3 cases occurred weakness of ankles and feet. Authors conclude that surgery should be advised and actively adopted for sacral tumors.
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PMID:[Surgical treatment of sacral tumor]. 1068 43

Case details were reviewed from 2021 patients treated surgically for nasal polyposis between 1991 and 1999, seen by six surgeons serving a catchment population of 805,000. The aim of this study was to determine the incidence of discrepancies between clinical and histological diagnosis. Twenty-two patients (1.1 per cent) were identified as having a lesion that differed histologically from the clinical diagnosis made at the time of surgery and which altered their further management. Amongst them were 11 cases of inverted papilloma, two of Wegener's granulomatosis; and two of sarcoid. The rest of the cases comprised three of squamous cell carcinoma, one of adenocarcinoma, one of myeloma, one of angiofibroma and one of microcystic papillary adenoma. In this series, the occurrence of malignancy, inverted papilloma, or other clinically significant pathology among the group of patients with otherwise clinically unsuspected histology justifies sending nasal polyps for routine pathologic examination. A cost-benefit analysis showed that, on the basis of 250 cases per year, the cost of laboratory and pathological services would be 12,000 Pounds, in comparison with the estimated average medicolegal cost of 51,000 Pounds per year incurred as a result of a delay in diagnosis together with the pain and suffering which would result given the case mix in this series.
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PMID:All nasal polyps need histological examination: an audit-based appraisal of clinical practice. 1154 14

Patients with chronic renal failure (CRF) have a high incidence of malignant tumours. Uremia thus induces a remarkable suppression of immune status. In this study, we report that within the last 20 years, 188 (6.7%) various organ tumours were found in 2817 CRF patients that were hospitalised and treated. 69 (36.7%) of 188 patients with various organ tumours were on hemodialysis and the rest (63.3%) were CRF without hemodialysis. 49 (71%) of the 69 patients with hemodialysis were diagnosed with tumours in the first year of the hemodialysis therapy. In 110 (84%) of 119 CRF patients tumours were detected in less than 10 years after diagnosis of CRF. Localisation of the tumours were: 39 (19%) urologic malignancy, 30 (16%) parathyroid adenoma, 28 (15%) skin malignancy, 19 (10%) gynaecologic malignancy, 18 (9.5%) gastrointestinal tract (GIT) malignancy, 17 (9%) lung malignancy, 17 (9%) larynx malignancy, 13 (7%) thyroid malignancy, 5 (2.6%) multiple myeloma and 5 (2.6%) malignant lymphoma. No patients in the series had received a transplant kidney or were therapeutically immunosuppressed for other reasons and obstructive uropathy. CRF patients have a several times greater risk of developing malignant tumour than the general population.
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PMID:Increased incidence of neoplasia in chronic renal failure (20-year experience). 1209 Mar 17

Hypercalcemia is a manifestation of a variety of both benign and malignant diseases. These conditions are not mutually exclusive, and we present a case report of a patient first diagnosed with the classic findings of multiple myeloma who, after appropriate therapy, demonstrated persistent hypercalcemia and was found on further testing to have an elevated parathormone level (PTH) and scintigraphic evidence of a benign parathyroid adenoma. Hypercalcemia responded to excision of the parathyroid adenoma. There are only 18 similar cases reported in the medical literature.
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PMID:Hyperparathyroidism accompanying multiple myeloma. 1602 48

A sixty six year old female presented with headache and decreased hearing. Clinical examination confirmed the presence of impaired hearing on the left side. Visual fields were full to confrontation and corrected visual acuity was normal. CT scan of brain revealed a pituitary mass. Preoperative anterior pituitary function was normal. Transsphenoidal decompression was performed, and histology was that of a plasmacytoma. Post operative pituitary function was normal. The patient had no symptoms or signs of multiple myeloma and subsequent investigations revealed no evidence of the disease. One year after diagnosis a course of radiotherapy was administered for local tumour recurrence. During seven years of follow-up, no evidence of multiple myeloma has emerged. Only thirteen similar cases have been described. Four of these had evidence of multiple myeloma at presentation and six progressed to it during follow-up. In twelve patients cranial nerve deficits were recorded. In any cases where it was documented, preoperative anterior pituitary function was normal. In a number of cases histology was reported initially as being that of a non-functioning adenoma, the true diagnosis being discovered, either by electron microscopy findings or after the development of multiple myeloma. Plasma cell tumours of the pituitary area are rare and can present with symptoms and signs indistinguishable from non-functioning adenoma. Atypical symptoms such as cranial nerve involvement or unexpected preservation of anterior pituitary function should arouse suspicion.
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PMID:Plasmacytoma: an unusual cause of a pituitary mass lesion. A case report and a review of the literature. 1632 66

We report an uncommon case of an intrasellar plasmacytoma presenting as a non-functional invasive pituitary macro-adenoma as the first manifestation of multiple myeloma. A 57 year old woman was referred to our department with a presumed diagnosis of a non-functioning pituitary macro-adenoma. She reported a 3 month history of headaches and a 2 week history of sudden onset of right facial numbness. Preoperative endocrine evaluation was remarkable only for a modestly elevated serum prolactin. A magnetic resonance imaging (MRI) scan revealed 3.6 x 5 x 4 cm enhancing homogeneous intrasellar mass with extension into the sphenoid and cavernous sinuses bilaterally; the optic chiasm was not displaced. She underwent transphenoidal surgery of the sellar lesion. The surgical specimen was heavily infiltrated with abnormal plasma cells, which stained almost exclusively for Kappa light chain immunoglobulins. An extensive investigation was undertaken to look for occult myelomatous disease. A diagnosis of multiple myeloma was made 1 month later based on a combination of clinical, pathological and radiologic features. She underwent radiation therapy directed towards the residual sellar tumor, followed by chemotherapy and autologous stem cell transplantation. Review of the world literature revealed only 22 previous reports of patients in whom a solitary plasmacytoma or multiple myeloma first presented as a sellar mass; in all cases mimicking clinically and radiologically a non-functioning invasive pituitary adenoma however with additional cranial nerve involvement. Intrasellar plasma cell tumors are rare tumors which may mimic non-functioning invasive pituitary tumors. The diagnosis should be suspected in patients with well preserved anterior pituitary function and cranial nerve neuropathies in the presence of significant sellar destruction.
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PMID:Intrasellar plasmacytoma presenting as a non-functional invasive pituitary macro-adenoma: case report & literature review. 1670 11

Using the Swedish Family-Cancer Database covering over 11.5 million individuals, estimated relative risks (RRs) for colorectal adenoma were using Poisson's regression. The RR of colorectal adenoma was found to be increased among first-degree relatives of patients with colorectal cancer (2.72; 95% confidence interval=2.46-3.00) and among the offspring and siblings of patients with endometrial and prostate cancers. We also found an increased risk of colorectal adenoma for the offspring of individuals with stomach cancer and leukaemia, and for siblings of those with pancreatic cancer and multiple myeloma. Our results suggest that colorectal adenoma may share a genetic aetiology with cancer even at extracolorectal sites. Increases of colorectal adenoma in families affected by prostate cancer and acute leukaemia cannot be attributed to known cancer syndromes, although the play of chance cannot be excluded.
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PMID:Association of colorectal adenoma with other malignancies in Swedish families. 1828 6

A 58-year-old previously healthy man presented with diplopia of rapid onset over a few days. Examination demonstrated bilateral sixth and right fourth cranial nerve palsy. MR imaging showed a large sellar mass with significant destruction of the pituitary fossa. Laboratory tests revealed very high serum prolactin (2,483 ng/dl, reference range 3-13 ng/dl). Dopamine agonist therapy was initiated with significant decline in PRL levels; however, nausea, fatigue, and anorexia developed. Within a few weeks the patient developed renal failure and hypercalcemia. Urine protein electrophoresis revealed large free monoclonal kappa peaks while extensive plasmocytosis was evident in bone marrow aspirates. On bone scan numerous lytic lesions were present. A transsphenoidal excisional biopsy was performed which demonstrated two distinct populations of cells, corresponding to a plasma cell tumor and a lactotroph adenoma. Treatment for multiple myeloma was initiated along with radiotherapy for the sellar tumor. Only a few cases of solitary plasmocytomas of the pituitary region have been reported. Few cases of prolactinomas coexisting with other sellar tumors has been described. We discuss in this report possible pathogenic and functional connections between these two tumors. We suggest that in the presence of extensive cranial nerve involvement, atypical imaging findings for a pituitary adenoma and severe hyperprolactinemia, the possibility of a collision tumor should lead the physician to consider excisional tumor biopsy or surgery in addition to dopamine agonist therapy.
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PMID:An unusual collision tumor comprising a prolactinoma and a plasmocytoma originating from the sellar region. 1884 27


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