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Query: UMLS:C0027651 (tumor)
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Hypertrophic osteoarthropathy and hypophosphatemic osteomalacia are both associated with neoplasm and unusual clinical syndromes. Although the etiologies of these conditions are unknown, their clinical courses are interesting, so we are reporting two cases of these conditions separately. Case 1: A 20-year-old man had an osteogenic sarcoma originating in the 2nd thoracic vertebra which was developing in the mediastinal region. He had complained of numbness and swelling in the left arm and of clubbing of the fingers of both hands. A chest radiograph showed a billiard-ball-sized, round opacity in the left upper mediastinal region. Periosteal new bone formation was demonstrated symmetrically in both humeri, radii, ulnae, femurs, tibiae, fibulae and metacarpals. Case 2: A 30-year-old man had complained of lower back, hip, knee and ankle pain and muscle weakness of five years' duration and was admitted to the National Yokosuka Hospital. Surum phosphorus was 0.7 mg/dl, alkaline phosphatase was 24.9 K.A. and glucosuria was noted. He had a fibrous xanthoma on the right thigh, and after removal of the tumor, his symptoms improved dramatically and pertinent laboratory data returned to normal. However, ossification of the ligaments of the spine subsequently developed.
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PMID:[Hypertrophic osteoarthropathy and hypophosphatemic osteomalacia associated with tumor]. 345 94

Spinal meningiomas are common as intradural-extramedullary neoplasm, but solitaly epidural spinal meningiomas are extremely rare. They may often be misdiagnosed as malignant neoplasms which are much more common in this location. Furthermore, at the time of operation, it is often difficult to distinguish the epidural meningioma from malignant tumors, even by the microscopic examination of the fresh frozen section. We present a case of spinal epidural meningioma, and emphasize the importance of preoperative neuroradiological examinations. A 26-year-old woman was referred to us from a neurologist of another hospital under the diagnosis of thoracic spinal tumor. She noticed sensory numbness in the lower extremities and thermal hypesthesia below the breasts about one year previously, and progressive gait disturbance about half a year prior to admission. Neurological examination revealed spastic paraparesis with hypesthesia of all modalities below T3. Plain films of the thoracic spine showed scalloping of the posterior margine of the T3 vertebral body. Metrizamide myelography showed a complete block at T3/4, and metrizamide CT revealed marked dural compression by an epidural mass which occupied the left side of the spinal canal from T2 to T4. The subarachnoid space all around the spinal cord was preserved comparatively well. The tumor was homogeneously enhanced by intravenous contrast enhanced CT scan, and the extracanalicular extension was not revealed. MRI [SE (400/25)] showed an iso-intensity signal tumor. Neither extracanalicular nor intrathecal extension of the tumor was showed. In addition to the possibility of the malignant tumors, we considered the possibility of spinal epidural meningioma. At operation, of highly vascularized, moderately firm epidural tumor was found invading the surrounding epidural fat.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Spinal epidural meningioma--a case report with special reference to neuroradiological findings]. 361 38

A 40-year-old woman had pain and numbness in the left upper extremity, on Dec. 1982. These symptoms progressed gradually. She was admitted to our department on Jan. 26, 1984 because of neck pains and progressive paraplegia. Neurological examination revealed monoplegia of the left arm with absent DTRs, spastic paraplegia, sensory disturbances below Th 11 level and severe sphincter disturbance. A metrizamide myelogram showed intradural extramedullary mass at C 4-7. Laminectomy was immediately performed from C 3 to C 7. A soft and brown tumor was attached at the ventral aspect of the cord at C 3 and C 7 and it was firmly attached at the root sleeve of the C 5 level. The histological diagnosis of the tumor was malignant schwannoma. One month later, she was discharged on foot. However, she was re-admitted to our department because of intractable pains in left neck and arm in Aug. '84. The second operation was done on Sept. 15. A soft and brown mass was found intra- and extradurally and it invaded into paravertebral muscules. On Sep. 30 '84 she died from respiratory failure. Postmortem examination revealed that intra-extradural tumor was found at C 4-Th 3, and the left brachial plexus was swollen. In the brachial plexus, the nerve fiber was replaced with tumor in the perineurium. The tumor invaded to the vertebral body and the paravertebral muscles. There were numerous metastasis of the tumor in both lungs. The tumor was formed by variable and scanty cytoplasm with many mitotic figures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[An autopsy case of malignant schwannoma in the brachial plexus extending into the spinal canal]. 379 Mar 59

Facial numbness and dysesthesia have not been emphasized as presenting features in spontaneous internal carotid artery dissection. Progressive facial pain, accompanied by oculosympathetic paresis, altered taste, and facial numbness suggest the possibility of basal skull neoplasm. We describe a patient, with previously undiscovered fibromuscular dysplasia, who presented with severe neck and face pain, dysgeusia, oculosympathetic paresis, and markedly reduced facial sensation due to a spontaneous vascular dissection. Altered facial sensation should now be included in the symptomatology of internal carotid artery dissection.
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PMID:Facial numbness and dysesthesia. New features of carotid artery dissection. 382 88

Tumors of the posterior fossa presenting orthostatic hypotension are rare and only nine cases have been reported so far. The locations of almost all these tumors were near the fourth ventricle and three of them were hemangioblastoma. A case of a tumor of the fourth ventricle showing autonomic disturbances mainly composed of orthostatic hypotension is reported. A 42-year-old male was admitted to the Department of Neurology of Chiba University Hospital on June 25th, 1981 because of three years' history of autonomic disturbances including orthostatic syncope, impotence, urinary disturbance and bowel dysfunction such as vomiting, diarrhea and constipation. He also complained of weight loss and staggering of gait to the left side. On admission, the patient was emaciated being 50 kg in weight and 172 cm in height. Neurological examination revealed hippus of bilateral pupils in light reflex, saccadic eye movement, slightly hypoactive deep tendon reflexes, mild terminal oscillations in bilateral finger-to-nose test, oscillation in the left heel-to-knee test, staggering tendency of gait to the left, slightly impaired tactile and thermal sensations in distal parts of the legs. Autonomic disturbances were showed by orthostatic hypotension (BP 104-50 in supine and 70-40 in sitting position), impotence, weight loss, anorexia, decrease of sweating, spontaneous yawning and loss of sensation of bladder fullness. About 5 weeks after admission, he began to complain of temporal headache and showed impairment of memory, drowsiness, paroxysmal apnea and papilledema.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Progressive dysautonomia in hemangioblastoma in the region of the fourth ventricle]. 396 90

Three patients with extensive retroperitoneal cancer are presented, in whom the psoas muscle was resected as part of a radical tumor excision. The resection of the psoas muscle, including the femoral nerve, which travels in its substance, and the genitofemoral and ilioinguinal nerves, caused little morbidity (denervation weakness of the quadriceps and anterior high numbness) and improved the quality of the excision. Ablation of the psoas muscle is technically possible; it may improve the patient's outlook both for palliation and for curative intent.
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PMID:Radical retroperitoneal tumor surgery with resection of the psoas major muscle. 401 84

The authors report a 11-year-old girl with a huge intraspinal malignant teratoma associated with spinal arachnoid cyst. At seven year of age, suprasellar tumor was diagnosed and the patient received radiation therapy for tumor bed with total dose of 4,225 rads. As the result, marked decrease of the size of tumor was seen by follow-up CT scan. Serum alphafetoprotein (AFP) and human chorionic gonadotropin (HCG) level were at 51ng/ml and 31IU/l when total dose of 2,000 rads were over, and they decreased to 3ng/ml and 6.6IU/l at the dose of 4,225 rads respectively. The histology of the suprasellar tumor was unverified. She was discharged without any neurological deficits. For next 24 months, she received intrathecal administration of Methotrexate by repeated lumber puncture in 14 times. She remained intact neurologically. At eleven years of age, four years later, she started complaining of the right leg pain. On the examination, hypesthesia in the L distribution and stiff neck with positive straight leg raising test were observed. Urinary and bowel function were intact. CT scan of the head revealed residual of the suprasellar tumor but the size of the tumor was unchanged. Myelography showed complete block at the level of L. Laminectomy at L was performed and brownish cyst was found in the intradural space. Aspiration of cyst content and cyst wall resection were carried out. Histology of the cyst membrane was arachnoid and spinal arachnoid cyst was diagnosed. The postoperative course was uneventful until 13th postoperative day, when acute progressive paraparesis and numbness of bilateral toes were seen.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A huge intraspinal teratocarcinoma associated with an arachnoid cyst in a child]. 404 21

There are 5 reported cases of meningioma complicated by chronic subdural hematoma so far as we reviewed. Considering frequency of occurrence, association of meningioma and chronic subdural hematoma is very rare. Recently, we experienced with a case of convexity menigioma complicated by chronic subdural hematoma. The patient was a 61-year-old woman who complained of headache and numbness of the left hand. She received hysteromyomectomy 28 years before but had no past history of trauma of the head. She suffered from frequent profound pain in both orbits for one year, and she consulted a neighboring practitioner due to occurrence of numbness of the left hand and malaise. Then, CT scan revealed abnormalities, so that she was referred to our center. On admission, neurological oxamination revealed no abnormalities but plain X-ray film of the skull showed a round destruction in the right parieral bone. CT scan showed a round high density area of 3 cm in diameter in the right parietal region, this is markedly enhanced with contrast media. There is a crescent-shaped low density area extending forward from the high density area. The body of the right lateral ventricle is totally collapsed. Selective arteriography of the right external carotid revealed tumor stain in the parietal region. Therefore, under the diagnosis of association of chronic subdural hematoma and convexity meningioma, craniotomy of the right frontal, parietal and temporal regions was carried out and a meningioma of 10 g, and a subdural hematoma with its capsule touching the maningioma were entirely extirpated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of convexity meningioma associated with chronic subdural hematoma]. 408 83

A 50-year-old male developed a sacro-coccygeal chordoma. Prior to the surgery, he had experienced back-pain, numbness of the right thigh and difficulty in voiding and defecation. Total excision of the mass was done and all symptoms were relieved. The light microscopic examination revealed a chordoma. The ultrastructural study was performed with particular interest in physaliferous cells. The fine structure disclosed the prominent associations of mitochondria and rough endoplasmic reticulum. The mitochondria showed irregularities in sizes and shapes but did not attenuate as much as previously reported. The vacuoles that were observed by light microscopy in physaliferous cells were both extra-cellular and intra-cellular and contained finely granular material of acid mucopolysaccharides probably of chondroitin type. The presence of both subplasmalemmal linear densities (SLD) and pinocytic vesicles was consistent with the histogenetic conviction that the tumor arose from mesodermal derivatives.
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PMID:Ultrastructure of chordoma. A case report. 408 5

Sixteen patients with advanced cancer were treated with recombinant-DNA-produced pure leukocyte A interferon (IFLrA) intramuscularly in doses ranging from 3 to 198 X 10(6) units. with interval periods of 72 to 96 hours between doses. At the two lowest doses of 3 and 9 million units, there was a cross-over evaluation between IFLrA and partially pure leukocyte interferon (IFN-C) produced from human cells. THe maximum observed serum concentration of IFLrA measured by enzyme immunoassay and bioassay increased with increasing doses. The mean serum concentrations of IFLrA and IFN-C were similar. Clinical effects produced by IFLrA and IFN-C were similar, including fever, chills, myalgias, headache fatigue, and reversible leukopenia and granulocytopenia. Eight patients had transient and mild numbness of the hands or feet, or both. Three patients developed low titers of antibody to IFLrA, Seven of 16 patients showed objective evidence of tumor regression during the study.
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PMID:Recombinant leukocyte A interferon: pharmacokinetics, single-dose tolerance, and biologic effects in cancer patients. 617 59


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