Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.01 seconds)

Five years ago, the use of preoperative chemotherapy for Wilms' tumor was adopted at this institution. Thirty children ranging in age from 5 months to 9 years had histologically confirmed Wilms' tumor (needle biopsy, n = 26; open biopsy, n = 4). Stage was determined by chest and abdominal computed tomography (CT) scan. Bilateral tumors were present in 6 children. All children received actinomycin D and vincristine from 3 weeks to 6 months before surgery. Seven children with bilateral tumors or stage IV disease also received adriamycin. CT-measured tumor masses shrunk in most cases. Subsequently, nephrectomy was performed in 23 patients and partial nephrectomy in 4, 2 of whom had bilateral disease. In 2 patients, residual bilateral well-differentiated epithelial tumor was not surgically resected. One child died before surgery. Reevaluation at delayed total or partial nephrectomy resulted in a downstaging of disease in 12 (41%). Further chemotherapy and radiation was based on the surgical stage. Postoperative chemotherapy (4 months to 2 years) was administered to all patients. The chest and/or abdomen were radiated in 12. Four patients (13%) died, 1 of radiation pneumonitis and 3 of the disease progression (2 with unfavorable histology, 1 of whom had bilateral disease). Two of 4 with unfavorable histology and 4 of 6 with stage IV disease have survived. It is concluded that this preoperative chemotherapy protocol is as effective as the National Wilms' Tumor Study (NWTS) protocol. The treated tumor is smaller, less friable, and easier to remove. Furthermore, because of downstaging, less radiation is necessary for cure.
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PMID:Preoperative chemotherapy for children with Wilms' tumor. 165 9

From 1955 to April 1989, 70 patients underwent bilobectomy for the treatment of primary lung carcinoma. Thirteen patients (18.6%) underwent right upper and middle lobectomy (UML), while 57 patients (81.4%) underwent right middle and lower lobectomy (MML). Indications for bilobectomy were cancer invasion into intermediate bronchus (34%), tumor extending to neighbouring lobe across a fissure (29%), interlobar lymph nodes metastasis with or without invasion to intermediate bronchus (24%), vascular invasion (5%), and others (7%). Squamous cell carcinoma was present in 31 patients, adenocarcinoma in 28, large cell carcinoma in 5, small cell carcinoma in 4 and others in 2. About 60 percent of the patients had Stage III or IV diseases. Postoperative complications occurred in 27 patients (38.6%) and 3 died within 30 days after operation (operative mortality rate. 4.3%). Pneumonia, empyema, atelectasis and arrhythmia were prominent postoperative complications. There were no statistically different postoperative complication rates between those with UML and those of MLL. Five-year survival rate of the patients with bilobectomy for lung cancer was 25.7%, which was between those with single lobectomy (36.9%) and those with pneumonectomy (5.6%). However, there was no statistical difference in 5-year survival rate among operative procedures in each stage.
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PMID:[An analysis of 70 patients with bilobectomy for bronchogenic carcinoma]. 165 64

Because of the independent and remote origin of the right upper and middle lobe bronchi, combined collapse of right upper and middle lobes is thought to be uncommon. We report 15 cases of combined right upper and middle lobe collapse found by plain chest radiograph in the past 8 years. Malignancies were confirmed in 13 cases. The other 2 cases with benign etiology included one case of endobronchial TB and one of pneumonia. These cases of combined bilobar collapse were possibly due to (1) the intraluminary infiltration of the primary tumor of the upper lobe to the middle lobe bronchus, (2) separated area of collapse produced by the primary tumor and its metastatic lymphadenopathy, (3) upper lobe tumor with external compression to intermediate bronchus that obstructed both the upper and middle bronchi, (4) multi-centric neoplasm, (5) tumor obstruction and sputum impaction at different bronchi, or (6) benign lesions operated at two different locations. The more frequent occurrence of bronchogenic carcinoma than that of benign lesions in our study revealed the invalidity of the "double lesion sign". Bronchoscopy or CT scan should be used to search for the etiology. If malignancy is confirmed in such condition, the prognosis is usually poor due to its advanced invasion.
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PMID:Combined atelectasis of right upper and middle lobes: a clinical study of 15 cases. 165 36

Pathomorphology of pneumonia induced by successive contamination of the Syrian hamsters with a pathogenic strain of Mycoplasma pneumoniae and an influenza virus A/PR8/34 as well as after contamination with an influenza virus against the background of a previous administration of the mycoplasma membrane fractions was studied. Mixed Mycoplasma-viral infection results in a tumor-like bronchiolar epithelium proliferation having a morphological similarity with bronchiolo-alveolar or acinar carcinoma, influenza virus infection against the background of a previous administration of protein fractions of mycoplasma membranes resulted in a chronization of pneumonia with development of several types of morphological changes: reversible tumour-like proliferation of the bronchiolo-alveolar epithelium, "inflammatory" pseudotumours and sarcoid-like granulomas.
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PMID:[Pathomorphology of chronization and outcomes of experimental mycoplasma-viral pneumonia]. 166 66

A patient with embryonal cell carcinoma restricted to the left testicle, without retroperitoneal but with mediastinal lymph node enlargement and highly elevated serum alpha-fetoprotein levels, is presented (T1N4M0). Because stage III of the disease was presumed, he received chemotherapy, which was unfortunately complicated by a bleomycin-induced pneumonitis. At re-evaluation after chemotherapeutic treatment, it appeared that the tumor marker level had decreased exponentially after the operation and that the mediastinal lymph node enlargement was due not to metastatic disease but to sarcoidosis. The necessity of calculating the half-life of tumor markers after operation and histological examination of the mediastinal lymph nodes prior to chemotherapy in such cases, is discussed.
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PMID:Testicular cancer with enlarged mediastinal lymph nodes: a diagnostic pitfall. 127 44

We tested the effectiveness of protected bronchoalveolar lavage (PBAL), performed through a protected transbronchoscopic balloon-tipped (PBT) catheter, in collecting distal airway secretions with a minimal degree of contamination. The PBAL had less than or equal to 1% squamous epithelial cells in 91% of specimens and an absence of bacterial growth in 59% of patients without pneumonia. Using a threshold of 10(4) cfu/ml we had one false positive result in 33 patient without pneumonia and one false negative in 13 patients with pneumonia. Quantitative bacterial cultures of the PBAL specimens had a diagnostic sensitivity of 97% and a specificity of 92%, with a positive predictive value of 97% and a negative predictive value of 92%. The diagnostic efficiency was 96%. The presence of intracellular organisms in much greater than or equal to 2% of the recovered alveolar cells (Giemsa stain) was seen in all but two patients with pneumonia (on corticosteroids) and in none of the patients without pneumonia. Gram stains of the PBAL specimens were positive in all but one patient with pneumonia and negative in all but one patient without infection (patient with endobronchial narrowing secondary to neoplasm with false positive cultures). Either the Giemsa or the Gram stain was positive in all patients with pneumonia, allowing early and accurate diagnosis of lower respiratory tract infection before the results of cultures were available. The time off antibiotic therapy before bronchoscopy did not affect the result of PBAL cultures, contrary to what we observed for the protected brush specimen.
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PMID:Protected bronchoalveolar lavage. A new bronchoscopic technique to retrieve uncontaminated distal airway secretions. 170 11

Most patients with pancreatic carcinoma are not curable. Surgical palliation of obstructive jaundice and gastric outlet obstruction leaves many patients with severe pain from pancreatic carcinoma. Anesthesiologists have drawn increasing attention to the successful use of postoperative percutaneous celiac plexus block for the treatment of pancreatic pain. Ironically, little attention has been paid to celiac plexus block during laparotomy. We reviewed the cases of 12 patients with pancreatic carcinoma and severe abdominal pain who were treated surgically. All patients had operative celiac plexus block with absolute alcohol at the time of exploratory laparotomy for biliary bypass, gastroenterostomy, or tumor biopsy. Complete postoperative pain relief was obtained in 10 of the 12 patients; two had only partial relief. No operative complications were related to celiac plexus block; one patient died postoperatively of pneumonia. Average postoperative hospital stay was 13 days and average postoperative survival was 3 1/2 months. Most patients had excellent pain relief for at least 2 months or until death. Because most patients treated surgically for pancreatic carcinoma are receiving only palliation with biliary bypass or gastroenterostomy, surgeons should pay increased attention to pain relief. Operative celiac plexus block is easy, safe, and highly effective in relieving the agonizing pain of pancreatic carcinoma.
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PMID:Improving palliation in pancreatic cancer: intraoperative celiac plexus block for pain relief. 170 54

The authors report a case of repeated brain metastases from hepatocellular carcinoma (HCC) in a 70-year-old male, who had underwent liver segmentectomy for HCC 5 years earlier. He developed intracerebral hemorrhage in the right parietal region, which was considered to be intratumoral because the metastatic tumor was detected in the same region. Total removal of the tumor and hepatic artery embolization followed by ethanol injection for recurrent HCC were performed. One month later, a metastatic tumor was discovered in the upper vermis and was totally removed. Both metastatic brain tumors were histologically verified as Edmondson grade 2 HCC. Four months later, multiple metastases to the left frontal region and the upper vermis occurred, and he died of pneumonia. Brain metastasis from HCC is rare; nine such cases have been reported in the literature, of which eight cases developed intracranial hemorrhage as in the present case.
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PMID:Intracranial hemorrhage due to brain metastasis from hepatocellular carcinoma--case report. 170 53

The authors present a rare case of malignant fibrous histiocytoma originating in the cranial bone. A 72-year-old male was admitted with a diffuse painless swelling in the left occipital region but no neurological abnormality. Plain skull x-ray films and computed tomographic scans showed a large tumor in the left temporo-occipital bone. The tumor invading subcutaneous tissue was totally excised and histologically diagnosed as malignant fibrous histiocytoma. Postoperatively, 40-Gy irradiation was given to the left temporo-occipital region. Several months later, however, the tumor recurred in the posterior fossa. Neuroradiological examination showed tumor extension into the occipital bone and muscle and the subdural space of the posterior fossa. A second operation extirpated all tumors except in the cerebellum. He died of pneumonia on the 14th postoperative day. Autopsy revealed malignant fibrous histiocytoma invading into the bilateral cerebellar hemispheres. Radiation and chemotherapy should be given as soon as possible following extensive surgery for malignant fibrous histiocytoma of the cranial bone.
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PMID:Malignant fibrous histiocytoma of the occipital bone with intracranial extension--case report. 172 Feb 11

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


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