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 (0.00 seconds)

This 6-month-old Caucasian boy presented with a 10-day history of lethargy, obtundation, inability to hold his head up and mild torticollis. MRI and CT scans showed a large solid and cystic mass involving the right temporal, parietal and occipital lobes, pineal, superior pons, mesencephalon and posterior right thalamus. He underwent craniotomy initially for a partial tumor resection with an intraoperative diagnosis of desmoplastic astrocytoma. With immunohistochemistry and special stains the diagnosis of desmoplastic infantile ganglioglioma (DIG) was made. A near total resection was performed a week after initial resection.The patient then was treated with chemotherapy. Two months later an MRI showed tumor growth. Following additional aggressive chemotherapy, an MRI at 5 months post-resection indicated further tumor progression. This case illustrates that some DIGs may behave more aggressively than typical WHO grade I lesions.
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PMID:December 2000: 6 month old boy with 2 week history of progressive lethargy. 1130 3

Stiff neck and torticollis are significant signs of neurologic disease. Nuchal rigidity is often associated with meningitis, subarachnoid hemorrhage, and posterior fossa tumor. Torticollis may be encountered in inflammatory disorders, such as cervical lymphadenitis, or it can be a sign of spinal cord syrinx or of central nervous system neoplasm. We report on three prepubertal children in whom stiff neck and torticollis were the presenting signs of pseudotumor cerebri. In all, the removal of 6-7 mL of cerebrospinal fluid led to prompt relief of symptoms and signs. We suggest that in the presence of unexplained stiff neck or torticollis in children, the optic discs should be examined to exclude pseudotumor cerebri.
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PMID:Pseudotumor cerebri manifesting as stiff neck and torticollis. 1195 32

Congenital muscular torticollis is a painless condition usually presenting during infancy with a tight sternocleidomastoid muscle causing the child's head to be tilted to the tightened side. Limited neck motion and a palpable tumor within the muscle are often present. A regimen of stretching exercises is the most common form of treatment with positive outcomes for over 90% of the identified cases. Rarely children require surgical intervention to release the tightened muscle. Botox injections to relax the tight muscle is a new form of treatment being used by some practitioners. Torticollis also presents as a symptom for a variety of muscular, bony, and neurologic conditions, which are briefly reviewed in this article.
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PMID:Congenital muscular torticollis. 1210 35

Nine black children with lymphoepithelioma, a rare malignancy of childhood, are the subject of this report. Unique clinical features included tender cervical lymphadenopathy with torticollis, trismus, epistaxis, and change in voice quality. A nasopharyngeal mass was demonstrable in seven children on careful examination, but none was resectable. Treatment with radiation alone or radiation plus cyclophosphamide resulted in complete tumor regression in eight of the nine children. Local recurrence or distant metastases occurred in four within 10 months, two of whom responded to additional radiation plus cyclophosphamide or adriamycin. At present, four children are alive without disease for periods of seven to 78 months, two are alive for seven to 53 months and are in remission from recurrent disease, and three have died with distant metastases. Freedom from disease for one year was associated with a favorable prognosis. Adjuvant chemotherapy appears warranted in view of the high incidence of local recurrence and distant metastases.
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PMID:Lymphoepithelioma in childhood. 1211 64

The sternocleidomastoid tumor of infancy (STOI), also known as fibromatosis colli, presents as a firm well circumscribed mass within the sternocleidomastoid muscle (SCM) in infants of 1-8 weeks of age. Some of these lesions are associated with torticollis, facial and cranial asymmetry. Incidence of STOI is approximately 0.4% of live births and usually 90% of the patients will have a good prognosis if therapy is initiated and continued for the appropriate period of time. This paper presents two cases of bilateral involvement of STOI, which is very rare. The bilateral nature of the masses added to the uncertainty of the clinical diagnosis and the unusual features of these cases are discussed.
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PMID:Bilateral sternocleidomastoid tumor of infancy. 1274 63

Infantile fibromatosis is a rare entity in children. Although the cervical region is one of the frequent sites of location for this tumor, the diagnosis may be delayed if it occurs in a usual location for a well-known entity, such as muscular torticollis or fibromatosis colli. The authors present an infant with infantile desmoid fibromatosis of the sternocleidomastoid muscle, which has been considered initially as olive of muscular torticollis.
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PMID:Infantile fibromatosis of the sternocleidomastoid muscle mimicking muscular torticollis. 1535 5

Congenital muscular torticollis (CMT) is the most common form of torticollis in children, significantly outnumbering orthopedic, neurologic, and ocular causes. CMT may present as a palpable sternomastoid tumor (SMT) or a simple tightness of the sternocleidomastoid muscle (SCM), designated as idiopathic muscular torticollis (IMT). Muscular torticollis has been associated with positional plagiocephaly in neonates who slept in the supine position. We have had difficulty in treating some of these combined cases by traditional methods such as physiotherapy, stretching exercises, and molding helmets. In November 2000, we began injecting botulinum toxin type A in cases in which there was persistent IMT, despite significant physical therapy input. The 15 patients included in this retrospective study all presented with IMT and positional plagiocephaly; all had responded poorly to conservative treatment, including physiotherapy, stretching exercises, or use of a helmet. In the attempt to avoid progression to surgical release, these patients were treated with botulinum toxin injected into the affected SCM and subsequent additional physiotherapy. All appeared to respond well, and a retrospective analysis of this treatment strategy was undertaken. Information gathered included a questionnaire, skull-shape tracings, and photographs. Independent outcome assessment data were then obtained from the regional child development teams and community physiotherapists. These results show that 14 of 15 children with recalcitrant IMT and positional plagiocephaly treated with botulinum toxin obtained sufficient improvement in neck range of motion and head position as to make surgical release of the muscle unnecessary. Our conclusion is that the use of botulinum toxin is a safe and effective adjunct to physical therapy in treating recalcitrant IMT; in selected cases, it may obviate the need for surgical release of a tight but nonfibrotic SCM.
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PMID:Treatment of recalcitrant idiopathic muscular torticollis in infants with botulinum toxin type a. 1575 Apr 34

Torticollis is either congenital or acquired in childhood. Acquired torticollis is not a diagnosis but rather a sign of an underlying disorder. The causes of acquired torticollis include ligamentous, muscular, osseous, ocular, psychiatric, and neurologic disorders and may be a symptom of significant abnormalities of the spinal cord and brain, such as spinal syrinx or central nervous system neoplasia. Torticollis is rarely considered to be an initial clinical presentation of posterior fossa and cervical spinal cord tumors. We report five cases of pediatric tumors with torticollis at the onset: an astrocytoma originating from the medulla oblongata, another presumptive astrocytoma of the spinal cord located between C1 and C6 cervical vertebrae (not operated), an ependymoma located throughout the whole cervical spinal cord extending into the bulbomedullary junction, an astrocytoma originating from the bulbus and extending into the posterior fossa, and another case of a eosinophilic granuloma located extradurally through the anterior and posterior portions of the vertebral bodies from C3 to C7 producing the collapse of the sixth cervical vertebra. All five cases were seen in children, aged between 3 and 12 years. All these cases reflect the misinterpretation of this neurological sign and the lack of association with the possibility of spinal or posterior fossa tumor. This delay in the diagnosis of these diseases led to progressive neurological deterioration and to the increase in the tumor size, which made surgical intervention difficult and the prognosis unfavorable. Although torticollis secondary to tumors is rarely seen, it is necessary to be kept in mind in the differential diagnosis.
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PMID:Torticollis secondary to posterior fossa and cervical spinal cord tumors: report of five cases and literature review. 1692 60

The case report describes use of real-time ultrasound guidance to facilitate percutaneous ablation of cervical nerve roots in a patient with Pancoast's syndrome. Distortion of anatomy by the tumor made it difficult to perform the procedure safely using fluoroscopy. A 64-year-old right-handed male patient with carcinoma of the left lung presented with severe pain in the left shoulder and the arm. A clinical diagnosis of the left brachial plexopathy secondary to tumor involvement of C5 to C8 nerve roots was made. Radiological appearance of the cervical spine revealed distorted anatomy because of severe degeneration of the cervical spine and guarding torticollis. Diagnostic prognostic block of the C4 to C7 exiting nerve roots was done under ultrasound guidance and resulted in more than 75% reduction in pain intensity for 4 hours. Ultrasound-guided percutaneous cervical rhizotomy was performed later. At 3-month follow-up, the patient still had complete pain relief as well as improvement in quality of sleep. Ultrasound-guided cervical nerve roots ablation is a feasible approach for patients with intractable neuropathic pain secondary to Pancoast's tumor. It can be a useful alternative to fluoroscopy in patients in whom a fluoroscopy-guided approach is deemed difficult and hazardous.
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PMID:Alleviation of Pancoast's tumor pain by ultrasound-guided percutaneous ablation of cervical nerve roots. 1850 22

Unilateral diffuse or localized enlargement of the sternocleidomastoid muscle (SCM) is an event commonly seen in infancy, and is popularly known as 'sternocleidomastoid tumor'. The condition, which usually spontaneously resolves with or without physiotherapy, is due to a hematoma following a difficult labor. The muscle regains its elasticity and complete function. In some infants it resolves with fibromatous changes in the muscle leading to shortening, fibrosis and finally culminating in torticollis. We describe a case of idiopathic diffuse enlargement of unilateral SCM in a 12-year-old child without any functional compromise or torticollis. The histopathological and clinical characteristics differentiating it from more commonly described sternocleidomastoid tumor or fibromatosis coli are described. We believe this is the first case report of idiopathic hyperplasia of SCM.
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PMID:Diffuse idiopathic hyperplasia of the sternocleidomastoid muscle in a child. 1984 86


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