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)

Peripheral polyneuropathy (PPN) is a rare complication of plasma cell neoplasia (PCN), occurring in less than one percent of the patients. Fifty-four such patients (including our 5) were reviewed. There were 42 men (78%) and 12 women (22%) aged 28 to 72 years. Forty-nine percent of patients were younger than 51 years at the time of diagnosis. The initial complaints were different from those observed in multiple myeloma in general, and were related to polyneuropathy in 80% of the patients. PPN was usually of a mixed sensory-motor type and most often involved all four extremities. Skeletal pain was less common than in myeloma in general, occurring initially in 15% and at diagnosis in 45% of the patients. In 21 patients, reversibility of neuropathy was observed. These patients were compared to those with irreversible neuropathy and found to be relatively younger and more aggressively treated with irradiation and modern chemotherapy. Elevated sedimentation rate was uncommon. Less than half of the patients had anemia, and six patients, all with osteosclerotic lesions, had polycythemia. Azotemia was detected in 44% of the cases. No hypercalcemia was observed in 21 examined patients. M components were usually of IgG class, and when the light chains of M components were examined they were invariably of lambda type. Often the level of M component was below 2.0 g/dl. In all patients the bone marrow was infiltrated with immature, abnormal-looking plasma cells, but the infiltrate was often limited to one or a few foci. Solitary plasmacytoma was observed in 14 patients. No anemia, hypercalcemia or azotemia was recorded in this group. Eight patients had serum M components. Bone marrow aspirate was usually normal. In seven patients definite reversibility of PPN was observed after irradiation of plasmacytoma. Twelve patients presented with osteosclerotic lesions (22%), 18 with both osteosclerotic and osteolytic lesions (33%) and 13 with osteolytic lesions. Forty-two percent of the patients had less than three visible lesions in the skeleton. Eleven patients had either osteoporosis or radiologically normal skeleton. The mean survival from the first symptom was about 28 months and from the diagnosis 20 months. The five-year survival was 21% and 20%, respectively. These observations highlight the differences between PCN with PPN and multiple myeloma without PPN.
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PMID:Plasma cell neoplasia with peripheral polyneuropathy. A study of five cases and a review of the literature. 624 19

Aminoglutethimide (AG) has antitumor activity in disseminated breast cancer similar to that of surgical adrenalectomy. AG works by blocking conversion of aromatase enzymes necessary for conversion of androgens to estrogens. Tumor response in patients with disseminated disease has been approximately 30%, with a further 13% of patients achieving stabilization of disease. Age and previous systemic treatment did not influence response to AG, except that those who had not responded to previous endocrine responded less well to AG. Relief of bone pain occurred not only in patients whose bone metastases objectively responded but also in some patients whose disease progressed. Side effects, although significant initially, usually subsided within 3 weeks; the incidence of side effects may be related to the rate of acetylation of the drug by the liver. In randomized clinical trials, AG has been shown to be as effective as adrenalectomy and tamoxifen therapy. AG was not as well tolerated as tamoxifen, but it was more effective in patients with bone metastases.
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PMID:The role of aromatase inhibitors in breast cancer. 636 51

A significant number of patients with newly diagnosed prostatic cancer will be found to have metastatic disease at time of presentation. Since the work of Huggins and Hodges in the early 1940s, endocrine manipulation and androgen deprivation have become the accepted methods of treating this group of patients. Approximately 70 per cent to 80 per cent of patients demonstrate positive clinical response. Many experience a decrease in the size of the primary tumor, a decrease in the levels of serum acid phosphatase, relief of bone pain, a decrease in bladder outlet obstruction, an increase in appetite, and a generalized improvement in their overall sense of well-being. Adequate hormonal therapy usually consists of estrogen administration of bilateral orchiectomy, but other modalities include administration of antiandrogens, progestational agents, androgen-synthesis inhibitors, and, recently, gonadotropin-releasing hormone analogues. This latter group may have increasing applications, particularly if the evidence indicating reduced side effects continues to be substantiated. The probability of producing a positive clinical response is increased when hormonal therapy is introduced at the time of diagnosis, at which point the tumor is still likely to be androgen dependent.
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PMID:Hormonal therapy in prostatic carcinoma. 638 92

Hypercalcemia and hypercalcemic crisis are common and often life threatening complications of neoplastic disease. Even moderately increased mobilization of skeletal calcium can result in significant osteoporosis. This in turn can give rise to pathologic fractures, often followed by pulmonary fat embolism and death. Bone pain is at times the first sign of neoplastic disease and the reason for seeking medical help.
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PMID:Experience with hypercalcemia and osteoporosis of neoplastic disease. 639 60

Twenty-nine patients with advanced prostatic adenocarcinoma were evaluated clinically, biochemically and radiologically and randomly assigned either to orchiectomy or to medical treatment. The latter consisted of the chronic administration of an LHRH agonistic analogue by parenteral and/or intranasal routes. Plasma testosterone levels fell to castrate values and remained so for as long as the follow-up lasted (24 months); estrogen levels fell as well. No change in basal cortisol, thyroxine or prolactin levels was noticed. A decrease in prostate size and improvement in prostatism occurred in all. Bone pain and radiology conventionally or by isotopic scanning, did not parallel the improvement seen in the primary disease locus. Similarly, the changes in alkaline phosphatase were minimal when compared to that of prostatic acid phosphatase. Both enzymes increased prior to or concurrently with relapse of the disease. The longest remission and survival was seen in patients with low enzyme levels, non diffuse bone metastases and high degree of tumor differentiation. Chronic use of agonistic analogues of LHRH induces effective castration in men with prostatic carcinoma and can replace orchiectomy or estrogen administration. The quantitative analysis of androgen receptors (AR) in subcellular fractions of tumor cells; the use of techniques to enhance the number of AR in the cytosol; and the determination of the type II/I regulatory subunit of protein kinase may be used to identify hormone independent clones and spare patients of unnecessary procedures.
Med Oncol Tumor Pharmacother 1984
PMID:Advanced prostatic adenocarcinoma: biological aspects and effects of androgen deprivation achieved by castration or agonistic analogues of LHRH. 644 76

Osteoid osteoma is a benign bone tumor occurring primarily in patients under the age of 30 yr. Bone pain at night and relief by aspirin or other nonsteroidal antiinflammatory agents is a common symptom complex. The proximal femur and spine are frequent sites of involvement, but almost any bone can be involved. If plain roentgenograms do not demonstrate the lesion, tomography or a bone scan may be helpful. Complete surgical excision is the therapy of choice with a low recurrence rate. Osteoid osteoma may present initially with symptoms suggestive of inflammatory arthritis, degenerative joint disease, neoplasm, or infection. This lesion can therefore be a difficult diagnostic problem, especially if routine roentgenograms are normal. A high index of suspicion is necessary to make the diagnosis.
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PMID:Osteoid osteoma: 95 cases and a review of the literature. 660 21

The patient, a 42-year-old female, presented with bone pain and a cervical tumor. The tumor was operated at another hospital under a diagnosis of thyroid adenoma and the bone pain subsequently disappeared. Three years later, a cervical tumor was palpated just under the operative scar; the patient experienced nausea, vomiting. The tumor and the left thyroid lobe were removed and modified radical neck dissection was performed. The histological diagnosis of the resected specimen was parathyroid carcinoma.
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PMID:[Parathyroid carcinoma--a case report and a review of the Japanese literature]. 671 62

Vinca alkaloids are effective anticancer agents. Vindesine is a recent vinca alkaloid derivative with anti-tumor effects shown in in vitro systems and in patients with acute lymphocytic leukemia (ALL). The present study was designed to investigate the therapeutic effectiveness and toxicity of vindesine in combination with prednisone for remission induction in late stage ALL in children. Sixteen children with late-stage ALL were treated with vindesine 4.0 mg/m2/week intravenously and prednisone 60 mg/m2/day orally in four divided doses for minimum of three weeks. Thirteen children were evaluable. Of these patients, four had complete remission and four had partial response. Toxicity was well tolerated and consisted of bone pain, paresthesias, loss of deep tendon reflexes, leukopenia, and thrombocytopenia primarily. Abnormal liver function tests and fever were also noted in some patients. All patients had received vincristine and prednisone prior to vindesine prednisone combination. All patients had been resistant to vincristine prednisone combination prior to vindesine prednisone treatment. This study suggests effectiveness of vindesine in late stage ALL and lack of cross-resistance of vindesine and vincristine.
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PMID:Vindesine and prednisone for remission induction in children with acute lymphocytic leukemia. 694 7

Hormone manipulation has been standard therapy for metastatic adenocarcinoma of the prostate for many years. Recently cytotoxic drugs have been studied, but their effectiveness has been limited, indicating the need for new therapeutic approaches. Based upon the hypothesis that cytotoxic drugs are most effective against actively proliferating cells, we have designed a clinical pilot study employing cyclical androgen priming to transiently stimulate tumor cells followed by cytotoxic chemotherapy with cyclophosphamide and methotrexate. There were nine responders (43%) out of 21 patients entered in the study, with a median duration of response that has not been reached at 9+ months. Survival was significantly better in responders than in non-responding patients. These results are similar to those of other studies in which chemotherapy was used alone. Chemotherapy toxicity with this schedule was mild. However, the androgen priming frequently resulted in increased bone pain, and there was one episode of spinal cord compression, suggesting that tumor stimulation was achieved. These results demonstrate the need for additional basic studies of the effects of testosterone on tumor cell kinetics before further clinical trials of this approach are initiated.
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PMID:Androgen priming and cytotoxic chemotherapy in advanced prostatic cancer. 712 58

A 39-year-old woman was hospitalized at our Institute following a diagnosis of "suspected systemic lymphopathy". The patient exhibited mediastinal tumefaction, moderate anemia, thrombocytopenia, leucoerythroblastic streak in peripheral blood, diffuse bone pain, slight fever, cough and dyspnea. The clinical picture, radiological findings and hematochemical data apparently suggested a diagnosis of epithelial neoplasia of bronchial origin, or a primary hemopathy. Only by means of an osteomedullary biopsy was it possible to establish that the disease was actually a bronchogenic carcinoma invading the marrow. In conclusion, both for a correct staging of patients with carcinoma, and for histological diagnosis, when the primary side can not be identified or attacked, the osteomedullary biopsy, if feasible carried out at different sites, proves to be the test of choice.
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PMID:[Importance of bone biopsies in the diagnosis of cancer metastases]. 727 67


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