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)

A 57-year-old female patient with known cardiac disease developed a 4 to 6 week history of diarrhea, followed by onset of orthopnea and subsequent right-sided cardiac failure. On hospital admission she was found to have pure tricuspid regurgitation, without evidence of cardiac ischemia, pulmonary embolism, bacterial endocarditis or pericardial disease. A 24-hour urine collection for 5-HIAA was elevated, and a subsequent octreotide scan documented abnormal uptake in the pelvic cul-de-sac. Bilateral ovarian masses were found at laparotomy, which on pathological examination were found to be a benign left ovarian cystic teratoma, and a right carcinoid tumor of the ovary. This patient presented with systemic complaints of diarrhea, and orthopnea and right sided heart failure that on evaluation were ultimately found to be due to a unilateral primary carcinoid tumor of the ovary, which accounts for less than 0.1% of all ovarian carcinomas, and only 5% of all carcinoids. Treatment of this malignant carcinoid syndrome presentation consisted of debulking of the tumor and continuation of her diuretics and digoxin. Diarrhea and orthopnea ceased within 2 weeks after her oophorectomy. On evaluation 6 weeks and 6 months postoperatively, her cardiac function was stable, though unchanged. 5-HIAA levels were within normal limits, demonstrating the curative function of surgery in patients with unilateral ovarian carcinoid without evidence of metastases, as well as preserved cardiac function in otherwise stable patients.
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PMID:A case of diarrhea and orthopnea in a 57-year-old female. 1106 Oct 23

A 37 year-old female underwent open heart surgery for a left atrial myxoma. The post-operative course was uneventful and she was discharged two weeks later. She had regular monthly follow-up in the outpatient department until 10 months postoperatively when she was readmitted to the orthopedic ward for excision of a left ankle tumor. Two days after admission, she developed severe orthopnea. The initial diagnosis was heart failure, and she was transferred to the medical ward for treatment. Transthoracic and transesophageal echocardiography revealed a recurrent left atrial tumor. Because of acute obstruction of the mitral valve and deterioration of her condition, she underwent emergent open heart surgery. The recurrent atrial tumor was excised; histopathologic examination revealed a myxoid sarcoma. Multiple tumors were found on this admission, including a mass in the neck and in the left forearm; computed tomography revealed a brain tumor in the left posterior frontal lobe and a chest wall tumor. She died two months later. Recurrent cardiac myxoma with multiple distant metastasis may have a malignant potential. Because of the potential for tumor recurrence, long-term and regular follow-up is mandatory.
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PMID:Recurrent cardiac myxoma with multiple distant metastasis and malignant change. 1126 65

The term myxosarcoma is currently not used in standard classification for soft tissue tumors, but restricted to cardiac tumors. Primary cardiac myxosarcoma is a very rare disease and is difficult to differentiate from myxoma clinically and pathologically. We report a case of left atrial myxosarcoma with widespread systemic metastasis in a 21-yr-old male. The patient presented with sudden onset of intermittent dyspnea and orthopnea. Echocardiography showed a mobile, pedunculated tumor, 7.5x5x2 cm in size, at left atrium. Histologically, the excised tumor showed an amorphous finely fibrillar and mucinous stroma, in which irregular cords and clusters of lepidic cells and large stellate cells with plump vesicular nuclei resembled the usual type of cardiac myxoma were noted. And it showed focally cellular area with great nuclear pleomorphism and frequent mitoses. The patient received combination chemotherapy, peripheral blood stem cell collection transplantation and operations for systemic metastases in the brain, skeletal muscle and lung. He is alive at present 37 months after initial diagnosis and has no more new metastatic lesion.
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PMID:Left atrial myxosarcoma with systemic metastasis: a case report. 1128 88

A 30-year-old woman presented to the Emergency Department with complaints of shortness of breath, orthopnea, and a severe reduction in exercise tolerance. The symptoms were the result of severe valvular heart disease that resulted from a bronchopulmonary carcinoid tumor. The carcinoid syndrome is a distinctive clinical syndrome seen in patients with carcinoid tumors. Cardiac valvular lesions are seen in the majority of patients with the carcinoid syndrome and represent the most clinically significant consequence of the carcinoid syndrome. This case report discusses carcinoid tumors, the carcinoid syndrome induced by these tumors, and the therapeutic options in the management of carcinoid tumors.
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PMID:The carcinoid syndrome: an unusual cause of valvular heart disease. 1139 83

Anesthetic management of a parturient with respiratory failure associated with hemoptysis, dyspnea, and orthopnea is difficult. An anesthesiologist should realize that the patient's major problem is not solved during the surgery. This circumstance is similar to a patient with associated cardiac disease scheduled for non-cardiac surgery. General anesthesia with endotracheal intubation can provide safe oxygenation for both the parturient and the fetus, but with possible unexpected massive hemoptysis and tumor seeding. Prolonged intubation may delay the patient's pulmonary treatment course. Laryngeal mask anesthesia can provide an airway, but must not be secured due to the risk of aspiration. The need of high doses of inhalation drugs may hinder uterine contractions. The addition of a muscle relaxant will change the patient's respiratory patterns and physiology. Regional anesthesia alone might not be tolerated. A decrease in cough strength, as well as dyspnea, orthopnea, and hyperventilation may be harmful to both the parturient and the fetus. However, we successfully managed this case using epidural anesthesia combined with assisted mask ventilation instead of spontaneous breathing usually provided by a simple mask in almost all American Society of Anesthesiology (ASA) class I-II parturients during cesarean section. The anesthetic level was maintained at T8 with 18 ml of 2% Xylocaine mixed with 2 ml of 7% sodium bicarbonate with 1:200,000 epinephrine epidurally and with the patient in a supine position with the head up at 30 degrees to prevent cephalic spreading and to ensure better pulmonary ventilation.
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PMID:Anesthetic management of a parturient undergoing cesarean section with a tracheal tumor and hemoptysis. 1265 13

ALK-negative CD30-negative peripheral T-cell lymphoma (PTCL) is an exceedingly rare neoplasm in children. Equally rare is the finding of cardiac involvement from lymphoma at presentation. The authors present a pediatric patient with PTCL involving the heart. The patient had orthopnea and an abnormal echocardiogram on presentation. After three doses of radiation, he died, and the autopsy showed massive infiltration of the heart and cardiac vessels by tumor. The authors review briefly the biology of PTCL and the incidence of cardiac involvement with lymphoma, which is not often appreciated prior to death.
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PMID:A case of childhood peripheral T-cell lymphoma with massive cardiac infiltration. 1470 14

A 69-year-old white woman presented with a 3-month history of progressive dyspnea, orthopnea, fatigue and weakness. Clinical, diagnostic imaging and echocardiographic investigations suggested an occult primary cancer with metastasis to the heart. The patient's condition deteriorated gradually, and she died 2 months later. At autopsy, a malignant tumor encasing the heart and a 1-cm solitary tumor nodule in the lower lobe of the left lung were found. Histologic and electron microscopic studies revealed a plasmacytoma predominantly involving the epicardium and a small solitary plasmacytoma located in the left lung. The two tumors were further confirmed by immunohistochemical studies that showed monoclonal IgG expression and kappa light chain restriction.
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PMID:Cardiac plasmacytoma. 1476 85

Most of benign mediastinal tumors are asymptomatic; however, sometimes we encounter emergent cases. In this article we discuss with regard to the situation that benign mediastinal tumors with severe symptoms need to be treated emergently. Any benign mediastinal tumors can cause respiratory and cardiac failure as they grow large enough to compress surrounding structures. It is very unique that the symptoms are relieved or worsen according to the patients' position. Rupture of mature teratoma is another situation which necessitates emergent therapy. The symptoms due to rupture depends on the site, that is pericardial space, intrapulmonary, and thoracic cavity. The mechanism of rupture is suspected to autolysis, infection, and necrosis of the tumor. Anesthesia is an important issue in treating such huge mediastinal tumors, because general anesthesia using muscle relaxants can introduce acute respiratory or cardiac failure. Patient's position is again very important, for example, in the patients with orthopnea anesthesia is sometimes initiated and the patient is intubated in sitting position. Although it is rare, we must be aware of these emergent situations when we treat patients with benign mediastinal tumors.
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PMID:[Benign mediastinal tumors]. 1536 60

Bronchial inflammatory polyps are defined as tumor-like lesions. They are usually related to chronic inflammatory processes in the adult. Because they may cause complications, they should be surgically removed. A 55-year-old male patient had been followed for recurrent pulmonary infections for 40 years. His main symptoms were orthopnea and hemoptysis upon admission to our hospital. A chest computerized tomography (CT) revealed bronchiectasis located at the right middle lobe and lower lobe and obstruction of the main bronchus at the level of carina. In bronchoscopy a mobile polypoid pinkish lesion protruding to the trachea was observed. We performed an inferior bilobectomy. The pathological examination revealed an endobronchial fibroepithelial polyp. The presence of a giant endobronchial polyp with chronic respiratory symptoms over an extended period of time and the rarity of information pertaining to these lesions in the literature provoked intrigue and constituted a worthy presentation.
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PMID:A giant endobronchial inflammatory polyp. 1630 9

A 58-year-old patient with recently diagnosed non-small cell bronchial carcinoma was referred to us with increasing shortness of breath and orthopnea by her family practitioner. To exclude the possibility of a pulmonary embolism, contrast medium-enhanced angio-CT of the thorax was performed. This showed a large mediastinal tumor, which, on the one hand, infiltrated and occluded the left upper lobe bronchus and, on the other, constricted the left pulmonary artery over a considerable part of its length. In view of the palliative situation and massively increasing dyspnea, balloon dilatation of the obstructed left pulmonary artery followed by stent placement was performed. This resulted in an immediate improvement of the symptoms. The originally strongly oxygen-dependent and heavily dyspneic patient could be relieved of the external supply of oxygen and was able to sleep normally without additional medication within 24 h. The patient was able ambulate freely within 2 days, with a markedly improved quality of life.
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PMID:Stent implantation for malignant pulmonary artery stenosis in a metastasizing non-small cell bronchial carcinoma. 1765 22


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