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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 69-year-old white man developed progressive symptoms of dysphagia for solids and liquids and regurgitation of undigested food accompanied by a 12-kg weight loss over a 4-month period. Initially, radiographs of the esophagus and stomach were normal, but when repeated 4 months later, a diagnosis of achalasia was suggested. Esophageal manometry performed at that time demonstrated a motor abnormality of the esophagus and lower esophageal sphincter consistent with a diagnosis of achalasia. Upper endoscopy revealed a small ulcerated tumor in the cardia of the stomach. A biopsy specimen was interpreted as adenocarcinoma of the stomach. Surgical treatment included resection of the gastric tumor along with a 4-cm segment of the distal esophagus, resection of a collar of apparently uninvolved stomach, and esophagogastrostomy. Nine months following surgery the patient was restudied. An upper gastrointestinal roentgenogram demonstrated a return of esophageal caliber and configuration to normal. Manometry showed that esophageal contractions had reverted to a normal progressive, postdeglutition pattern throughout the length of the esophagus. This is the first report in which achalasia secondary to gastric adenocarcinoma was reversed after tumor resection.
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PMID:Return of esophageal peristalsis in achalasia secondary to gastric cancer. 729 73

While oesophageal obstacles are responsible for regurgitation or aspiration in neonates and infants, older children present with dysphagia. Before any investigation, a buccopharyngeal infection must first be eliminated clinically. In the absence of fever, the ingestion of a foreign body or caustic substances must be considered, either in an acute context, or in a chronic context related to cicatricial stenosis. Tumour or congenital lesions are less common, whether intrinsic (stenosis, fistulas, duplications), or extrinsic (vascular malformations, mediastinal tumours). Radiological investigation is based on simple techniques: chest X-ray and barium swallow are usually sufficient to establish the aetiological diagnosis.
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PMID:[Dysphagia in children. Imaging]. 774 55

Right-sided valvular heart disease is a common complication of metastatic carcinoid tumors. On the contrary, left valve involvement is a rare finding. In our report we describe a patient in whom the subsequent involvement of right and left heart valves was documented by 2D and Doppler echocardiography. The patient was a 46-year-old woman who, in the last three years, complained of face flushing, postprandial diarrhea and shooting epigastric pain lasting for hours. She came at our observation for increasing dyspnoea, peripheral edemas and asthenia. 2D-echocardiography and Color Doppler revealed a severe tricuspid regurgitation and a turbulent blood flow across the pulmonary valve. An Angiographic examination confirmed the severe tricuspidal regurgitation and disclosed a mild pulmonary stenosis. These findings were associated with high 5 hydroxyndole acetic acid (5-HIAA) urinary excretion and the presence of a liver metastasizing ileal carcinoid tumor. Some months later, a new 2D echo-Doppler examination showed thickening and reduced motion of the posterior mitral leaflet, associated with regurgitation and an aortic insufficiency without evident structural valvular abnormalities. Even if carefully investigated no right-to-left shunt was found.
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PMID:[Left valvular involvement in carcinoid: description of a case]. 805 18

Surgical treatment of a right atrial myxoma with a right-to-left shunt and coronary artery disease was successfully performed in a 61-year-old man. The interatrial shunt occurred through a patent foramen ovale and was the result of a high central venous pressure due to tricuspid stenosis and regurgitation. Instead of right heart catheterization and cardioangiography, we chose an intraoperative blood-gas study to diagnose the intracardiac shunt. Preoperative polycythemia and hypoxemia were improved after removal of the tumor and closure of the patent foramen ovale.
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PMID:Right atrial myxoma with right to left shunt and coronary artery disease. 813 95

The authors report a case of carcinoma arising in a longstanding Zenker's diverticulum, in a 66 years old man that refused surgical treatment for 25 years. Three months prior to his admission to our hospital, an exacerbation of his dysphagia, which became severe, was observed; and so was regurgitation, with passage to the airway during swallowing or when asleep. The esophagram showed the diverticulum without images suggestive of neoplasm, and with spilling of barium into the tracheobronchial tree. Esophagoscopy was refused by the patient. After surgical diverticulectomy, a thickened area in the inferior portion of the diverticular body was observed, which was histologically reported as a squamous cell carcinoma with pearl formation, involving only the diverticular wall. Complementary radiotherapy with TCT was administered over the esophagus, mediastinum and supraclavicular lymphatic areas, with a total dose of 5000 Cgy. Concomitant chemotherapy with Mitomycin and 5-Fluorouracil was administered. After a 2 year follow-up, the patient is completely asymptomatic. We discuss etiopathogenic factors, clinical manifestations, diagnostic procedures, and therapeutic possibilities.
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PMID:[Carcinoma in a long-standing Zenker's diverticulum]. 820 85

The role of CT and MRI in the diagnosis of heart failure include evaluation of cardiac function and pathological diagnosis. Recently, both CT and MRI have achieved a marked progress in the time dissolution function. As a result, ultrafast CT and gradient field echo (FE) MRI are now available for evaluation of cardiac function. However, the former is yet to become popular because of its extremely high cost. On the other hand, various methods have been devised for blood flow measurement, which is also possible by MRI. CT and MRI provide useful information for detecting the cause of heart failure. With CT, diagnosis of calcification of pericardium, valves, aorta and coronary artery, that of pericardial effusion retention, congenital heart and great vessel disease, intracardiac tumor and thrombosis, as well as, morphological diagnosis of dissecting aneurysm of aorta are possible. Helical CT provides highly continuous three dimensional information. MRI is also available for morphological diagnosis of congenital heart diseases while it is possible to detect valvular regurgitation and shunt flow with FE method. There is a possibility of elucidating the energy metabolism of phosphoric acid by MR spectroscopy. CT and MRI is considered more useful in the pathological diagnosis of heart failure rather than in the evaluation of cardiac function. Further progress in these fields is expected in the future.
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PMID:[Progress of clinical diagnosis of heart failure]. 833 92

History taking is the first step in the evaluation of a patient. An analysis of the information obtained provides the basis for the choice and order of diagnostic tests. In addition, it provides the clinician with the necessary information to determine the relevance of "abnormal tests" to the patient's problem. Dysphagia is a reliable symptom that indicates an abnormality in the swallowing mechanism. The history should contain a detailed description of the symptoms associated with dysphagia from the onset. Especially relevant are questions to determine if dysphagia is experienced every day or intermittently, with solid food or liquids or both, as well as presence and timing of associated symptoms such as, choking, coughing and regurgitation, changes in speech, heartburn and chest pain. It is clinically useful to divide swallowing into three phases: oral, pharyngeal and esophageal. Oral dysphagia is usually due to a neurologic disorder, decreased salivary flow or painful oropharyngeal lesions. Pharyngeal dysphagia is most frequently caused by neuromuscular disorders and less frequently by a Zenker's diverticulum, neoplasm or a mucosal web. Esophageal dysphagia is caused by a structural narrowing, such as produced by a peptic stricture, neoplasm or a Schatzki's ring or by a primary motility abnormality, such as achalasia or diffuse esophageal spasm or by motility abnormalities produced by inflammation caused by gastroesophageal reflux, medication-induced esophageal ulceration or infectious esophagitis.
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PMID:Art and science of history taking in the patient with difficulty swallowing. 846 26

We describe the case of an intrapericardial pheochromocytoma located in the anterior surface of the heart and spreading over the pulmonary trunk. Under cardiopulmonary bypass (CPB) the tumor was removed. "En bloc" resection of the anterior wall of the right ventricular infundibulum and the pulmonary trunk was performed, with implantation of a fresh aortic homograft in the pulmonary position to avoid free pulmonary regurgitation.
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PMID:Intrapericardial paraganglioma. 874 67

A 66-yr-old man had undergone a total gastrectomy with esophagojejunostomy for gastric cancer 29 yr previously. Soon after the operation, he began to suffer frequent bile regurgitation and subsequent alkaline reflux esophagitis. A small esophageal tumor was found incidentally above the esophagojejunostomy at a follow-up endoscopy, and he subsequently underwent a lower esophagectomy in 1995. The resected specimen revealed evidence of an early adenocarcinoma arising in a short segment of columnar cell-lined esophagus which had not been grossly evident prior to the esophagectomy. The present case indicates that columnar metaplasia with a neoplastic potential can be induced in the esophagus by the chronic reflux of duodenal contents in the absence of gastric acid.
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PMID:Early esophageal adenocarcinoma arising in a short segment of Barrett's mucosa after total gastrectomy. 879 16

We herein report a 36-year-old man who underwent surgical resection for myxoma. Preoperative two-dimensional echocardiography demonstrated a mass in the right ventricle. Intraoperatively, the tumor was found to derive from an anterior papillary muscle of the tricuspid valve. The tumor was successfully excised and the tricuspid valve was repaired with chordoplasty and annuloplasty. A histopathological examination revealed myxoma and a 2-year follow-up has shown no evidence of recurrence or tricuspid valve regurgitation.
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PMID:Right ventricular myxoma: report of a case. 906 13


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