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

Fibrolipomatous hamartoma of nerve is a rare, tumor-like fibro-fatty growth arising from the epi- and perineurium. It mainly affects peripheral nerves and the median nerve in particular. An association with Klippel-Trenaunay syndrome and macrodactyly has been described. We present a 30-year-old patient, in whom the diagnosis of Klippel-Trenaunay syndrome had been made at the age of two, based on macrodactyly of the right hand. Because of increasing functional limitation and pain, the patient was referred to our department, after angiographic exclusion of Klippel-Trenaunay syndrome, for operative reduction of the tumor. Histologic examination revealed a fibrolipomatous hamartoma of the nerve. Further treatment consisted of surgical tumor reduction, which resulted in satisfactory recovery of function in the right hand. After eight months follow-up, the patient was able to perform all normal daily activities, and there was no evidence of recurrence of the lesion. Diagnostic evaluation of macrodactyly is necessary, since there may be an underlying cause such as fibrolipomatous hamartoma of a nerve, which if corrected early by surgical excision may prevent long-term disability.
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PMID:[Fibrolipomatous hamartoma of the nerve--a rare etiology of macrodactyly. A case report]. 1008 63

Osteosarcoma generally has a poor prognosis. Osteosarcoma of the mandible is rare and may have a less aggressive course. Three patients with osteosarcoma of the mandible were treated during the past 19 years at National Taiwan University Hospital. All were women, with an average age of 49 years. The patients were treated with radical excision of the tumor, with either pre- or postoperative radiotherapy. None of the patients received chemotherapy. Reconstruction with iliac osteocutaneous free flap, fibular osteoseptocutaneous free flap, or Leibinger reconstruction plate was performed to repair the facial defects resulting from tumor resection or radiation-induced necrosis. The three patients were alive and without evidence of recurrence at the time of writing, with follow-up periods ranging from 7 to 18 years. All had acceptable facial contour and satisfactory oromandibular function after reconstruction. These results support the effectiveness of wide resection with radiotherapy for treatment of mandibular osteosarcoma. With the availability of microsurgical reconstruction and biocompatible reconstruction plates, we advocate extensive ablation of this tumor. Long-term survival, good functional recovery, and acceptable facial contour can be expected.
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PMID:Long-term survival of patients with mandibular osteosarcoma. 1070 95

Traditional rectal cancer surgery has been burdened with a high rate of sexual and urinary dysfunctions due to intraoperative injury or the cutting of the sympathetic and/or parasympathetic nerves. The experience acquired in the last ten years with total mesorectal excisions has permitted the use of the "nerve-sparing" technique. The present study regards 239 patients from two surgical centres, most of whom underwent sphincter-saving radical surgery between 1994 and 1998 with the above mentioned technique for resectable colon cancer. Details regarding the technique were recorded in the last 58 patients, in order to examine the severity of the surgical damage. The subgroup with the longest follow-up, which included 36 patients, was diagnostically evaluated by a surgeon, psychologist, urologist and neurologist to analyze the risk of sexual and urinary dysfunctions. A complete nerve-sparing was performed in 86.3% of the cases. The parasympathetic nerve trunks were those most often damaged because of perineural tumor spreading. Partial to complete sexual impotence was observed in 44% of the patients and surprisingly, preoperative dysfunctions were detected by means of the multidisciplinary approach in one third of these patients. Therefore, only 30.5% of the patients presented with strictly postoperative sexual impotency, above all, those who had undergone high-dose preoperative chemoradiation for T3 or T4 middle to low rectal cancer. A prospective study was initiated to evaluate the genitourinary dysfunctions after rectal cancer surgery in all of the clinical phases by means of a multidisciplinary approach aimed at functional recovery and improved quality of life.
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PMID:Nerve-sparing surgery in rectal cancer: feasibility and functional results. 1084 Sep 33

The aggressiveness of hypopharyngeal cancer makes broad resectioning of the circular pharyngolaryngoesophageal segments necessary, followed by reconstruction to restore the anatomical gap created as fully as possibly creating a neoesophagus with thin walls that can easily be released. Over the years several procedures have been fine tuned for reconstruction of the upper digestive tract employing transposed viscera, miocutaneous pedunculated flaps, revascularized fascio-cutaneous or visceral free flaps. Currently the revascularized jejunum loop is one of the most commonly used methods in the reconstruction of the hypopharynx. Its popularity is due to some anatomical and physiological advantages: it requires transposition of a brief intestinal tract anatomically well adapted to the reconstruction site, ensuring rapid functional recovery. The authors report the oncological and functional results obtained in 25 patients who underwent circular pharyngolaryngectomy followed by reconstruction with a revascularized jejunum loop. The percentage of transplant survival was 90% and local and general complications were reduced to a minimum. The functional results--both in terms of deglutition and phonation--were satisfactory while patient survival (6-37 months follow-up) was in line with that reported by other authors for the same tumor (47%). Although prognosis for hypopharyngeal-esophageal neoplasms is still quite poor, this experience shows that circular pharyngolaryngectomy followed by reconstruction with autotransplant of the jejunum is an excellent choice since it offers the patient a prompt, acceptable functional recovery and a fair quality for his remaining life.
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PMID:[Revascularized jejunum loop in hypopharyngeal reconstruction: oncological and functional results]. 1088 53

We examined short duration perception (400 ms), long duration estimation (30 and 60 min), and spatiotemporal estimation in long-term survivors of childhood cerebellar tumors with a mean time since diagnosis of 14.2 years. Groups of individuals with tumors treated with surgery only (astrocytoma, N = 20) were compared to those with tumors treated with surgery, focal radiation, and craniospinal radiation (medulloblastoma, N = 20), and to age-matched controls (N = 40). Childhood lesions of the cerebellum produced enduring deficits in short-duration perception, but spared the ability to functionally estimate long durations, regardless of the pathology or treatment of the tumor. Evidence did not support any functional recovery over time of the cerebellar system that underlies short-duration perception. Younger age at treatment was not a protective factor. Although no group differences were present in the functional measures of long-duration estimation, tumor-related prospective memory deficits interfered with the ability to produce long-duration prospective estimates. The utilization of sensory and somatomotor information to refine real-world spatiotemporal estimates was compromised in the medulloblastoma group only.
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PMID:Perception and estimation of time in long-term survivors of childhood posterior fossa tumors. 1101 15

The author reports a case of a 11-year old child presented with peroneal nerve entrapment secondary to proximal fibular osteochondroma, with complete recovery of function following the excision of the tumor.
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PMID:Peroneal nerve palsy secondary to proximal fibular osteochondroma--a case report. 1181 60

The authors report a case of immediate facial reanimation resulting from functional latissimus dorsi musculocutaneous flap transfer and funicular grafting of the thoracodorsal nerve after cheek tumor ablation. After wide excision of the tumor, including the facial nerve except the temporal branch and part of the zygomatic major muscle and masseter muscle, the authors reconstructed the cheek skin and provided movement by performing a small-segment latissimus dorsi musculocutaneous flap transfer using Harii's method and the defect of the buccal and marginal mandibular branches of the facial nerve by funicular grafting from one of the two funicles of the thoracodorsal nerve. After 6 months, the transplanted, small-segment latissimus dorsi muscle showed good voluntary movement, and the lower orbiculus oris and depressor oris presented good functional recovery. The authors believe the two funicles of the thoracodorsal nerve can be used independently for two purposes: one for functional segmental muscle transfer and the other for nerve grafting to defects of branches of the facial nerve. This concept makes it possible to reconstruct multiple facial movements while minimizing donor site morbidity by means of immediate facial reanimation.
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PMID:Split thoracodorsal nerve funicular graft combined with functional latissimus dorsi musculocutaneous flap transfer for immediate facial reanimation after tumor ablation. 1206 27

Hypopituitarism is a disease complex with variable clinical manifestations. Recent studies have improved our understanding of its pathophysiology, particularly in patients with pituitary adenomas. In that setting, hypopituitarism was previously considered a permanent and irreversible process, requiring life-long hormone replacement therapy. While this could be true in some instances, recent data demonstrated recovery of pituitary function in a large number of patients with hypopituitarism following surgical decompression. Mechanical compression of portal vessels and the pituitary stalk, by the expanding adenoma was postulated to be the predominant mechanism causing hypopituitarism in this setting. Since portal vessels also provide blood supply to the anterior lobe, ischemic necrosis of portions of the pituitary can occur as a result of increased and prolonged compression by the expanding adenoma. Recent data demonstrated increases in intrasellar pressure (ISP) in patients with pituitary macroadenomas, particularly those with hypopituitarism. The data showed that ISP measurements correlated positively with the serum prolactin levels but not with tumor sizes. It is postulated that increased ISP has predominant role in the pathogenesis of hypopituitarism in patients with pituitary adenomas while. The increase in ISP results in decreased blood flow through the portal vessels and the pituitary stalk. The latter will result in diminished delivery of hypothalamic hormones to the anterior pituitary and may also cause ischemia and/or necrosis in some portions of the normal gland. Recovery of pituitary function can thus be anticipated after surgical decompression, in patients who have viable pituitary cells. Understanding the pathophysiology of hypopituitarism and recognizing the probability for recovery of function should be emphasized in the management of patients with this disease. An important aspect of the management is patients' education about their disease, including the use of medic alert identification. The managing physician should appreciate the variable clinical manifestations of the disease and the possible occurrence of other associated neuroendocrine, neurological and neuro-ophthalmologic signs and symptoms. Treatment of hypopituitarism should not be rigid but instead, always individualized. Management should take into consideration the patients' age, sex, education, original disease process and clinical history.
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PMID:Medical management of hypopituitarism in patients with pituitary adenomas. 1267 8

Apoplexy in young adults is due to rupture of an artery or to obstruction, as by clot, by embolus, or by transitory vasospasm. In differential diagnosis, tumor and demyelinizing disease must be considered. Spinal fluid study helps to differentiate between hemorrhagic stroke and stroke due to vascular block. In hemorrhagic stroke, search for the site of bleeding is imperative and angiography, the preferred method of study, should be carried out as soon as the patient's general condition permits. In vascular occlusive stroke, measures to maintain the blood pressure and to dilate collateral channels are often helpful. Stellate block is most valuable in the acute phase immediately following embolism or thrombosis. In a small percentage of chronic cases, stellate block may be followed by significant recovery of function. Benefit may also be derived at times from systemic vasodilators such as niacin and intravenously administered histamine.
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PMID:Apoplexy in young adults diagnostic and therapeutic observations. 1487 75

Basic studies were carried out to apply frozen allogeneic nerve grafts in dogs after wide-ranging defects of the brachial plexus due to surgical resection of tumor. In this study, morphological variations in branching patterns of the brachial plexus were examined in ten beagle dogs, to evaluate whether the brachial plexus might represent a useful source of allogeneic nerve grafts. Spatial relationships between the axillary lymph node, which had the possibility of carcinomatous metastasis, and the musculocutaneous (MC) nerve, which was important for the function of the forelimbs, were also investigated. In all ten cases examined, the brachial plexus received ventral roots from the fifth cervical nerve to the first thoracic nerve. No significant variation in the branching pattern was found in any nerve except the phrenic, MC and dorsal thoracic nerves. Four communicating branches were observed and had some morphological variations which might be negligible for nerve grafting. Considering previous physiological and anatomical reports, the most important nerve to be reunited in graft operations for functional recovery is the radial nerve. The MC nerve and median or ulnar nerve should also be considered as possibilities for reuniting. Distances between the axillary lymph nodes and the MC nerve ranged from 11.2 mm to 21 mm (mean +/- SD: 16.1 +/- 2.3 mm). In conclusion, it was suggested that morphological variations in the brachial plexus were technically acceptable to apply allogeneic nerve grafts at least in beagle dogs.
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PMID:Morphological variations in brachial plexus of beagle dogs: evaluation of utility as sources of allogeneic nerve grafts. 1529 46


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