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

From June 1975 to August 1977, 19 patients with distant metastases of malignant melanoma of the skin that were no longer responsive to chemotherapy were treated with BCG given intravenously. A single dose of lyophilized Pasteur BCG ranging from 2 X 10(7) to 3 X 10(8) viable units was given in 500 ml of saline infused in 5 to 6 h. Seven of the 16 evaluable patients benefited from treatment; 3 showed an objective regression of more than 50% of the original tumor volume, and 4 an arrest of tumor growth. The objective regressions lasted from 2 to 5 months, and 1 case had an arrest of tumor growth for 29 months. The regression rate was related to the BCG dosage: 2 X 10(8) viable units appears to be the dosage that gives severe but reversible toxicity and is able to induce objective regression. The most responsive lesions were skin and subcutaneous deposits (5 of 7) and lung metastases (1 of 4). Toxic effects seem to be related to the number of bacilli injected. In the group of 10 cases treated with less than 10(8) units, toxicity was modest: 4 patients had fever (up to 38.5 degrees C) that lasted a few days, and in 3 cases it was associated with shivering during the infusion period and weakness. One case only had vomiting and jaundice. Toxicity was severe in the 9 patients that were treated with a dosage higher than 10(8): patients had fever and weakness for at least 4 days and shivering during the infusion. Two had adrenal insufficiency and 7 had liver enlargement and jaundice with return to normality by day 21. In the whole series 8 patients had leucopenia and 5 thrombocytopenia for 2 to 3 days: only 1 patient required blood and platelet transfusion. No significant variations in immunoglobulin levels were observed. No variations of PPD or BCG skin tests were observed after treatment. Three patients expired; the first treated with 6 X 10(7) unit, had an intercurrent disease (autopsy showed a heart infarction); the second, treated with 1.8 X 10(8), showed a rapid growth of lung metastases and died 15 days after treatment; the death of the third patient was probably due to anaphylactic shock. All 3 patients had been previously treated with BCG, given by scarification or intranodular injection.
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PMID:Intravenous administration of BCG in advanced melanoma patients. 68 66

Malignant tumors are known to have a "remote" or nonmetastatic effect on the central and peripheral nervous systems. Eight patients were seen with proximal muscle weakness in association with bronchogenic carcinoma (5), carcinoma of breast (2), and leukemia (1). Electromyography demonstrated small polyphasic motor unit potentials. Muscle biopsy, however, showed evidence of denervation. Electron microscopy revealed morphological abnormalities in the intramuscular segments of axons. This combination of EMG and biopsy findings is presented as evidence for a remote effect of tumor on the intramuscular distal axons.
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PMID:Weakness in malignancy: evidence for a remote effect of tumor on distal axons. 71 40

The authors report a series of 100 consecutive patients with spinal metastases causing cord or cauda equine compression, who were treated with surgical decompression. Of these, 30% (all women) had breast cancer. The most common primary neoplasm in man was prostatic carcinoma. Pain was the earliest and most prominant symptom, followed by weakness. Bladder dysfunction was recorded in 40 patients. The thoracic region was the most common site of cord compression (76 patients). Surgical treatment involved urgent and extensive laminectomy decompression. Concomitant spinal stabilization was required in 10 cases, involving posterior rib graft fusion in seven and Harrington rod instrumentation in three. At last follow-up review, 29 of these patients were living with an average postoperative survival of 2.3 years; 71 patients had died with an average survival of 8.8 months. Surgical decompression produced effective pain relief in 70% of the patients. Postoperatively, 58 patients could walk; of these, 40 were walking and continent of urine 6 months following surgery (including five patients who were totally paraplegic on admission). Positive approach and aggressive management in this problem can achieve results superior to those generally reflected in the literature.
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PMID:The neurosurgical management of spinal metastases causing cord and cauda equina compression. 73

In 1972, Neault and his co-workers reported seven cases of uveitis associated with intracranial reticulum cell sarcoma. Recently we have experienced a similar case for the first time in Japan. A 32-year-old woman registered on March 10, 1971, complaining of blurred vision in the left eye for about two weeks. By ophthalmic examination, left posterior uveitis was diagnosed but the etiology was unknown. Treatment with corticosteroids was begun, but her left eye continued to fail in spite of the treatment. In August, 1971, she complained of weakness of left arm and leg, and in October, she suffered from severe headache and vomiting. At that time, uveitis appeared in the right eye too. Neurological findings and carotid angiogram indicated a right cerebral lesion. On November 5, 1971, a right frontoparietal craniotomy was performed but no tumor was found. Since then her neurological and eye symptoms had been progressively worse. The patient died on July 12, 1972. Postmortem examination revealed the tumor infiltrating in the bilateral diencephalon, left internal capsule, left lenticular nucleus, left temporal lobe, midbrain, pons, left dentate nucleus, optic chiasma and intracranial portion of the optic nerves. But no tumor was found at any other parts of the body. Histologically the tumor was a reticulum cell sarcoma. The eyeballs were not examined histologically, but the uveitis in this case was thought to be closely related to the intracranial reticulum cell sarcoma. If the uveitis is resistant to the treatment, we must consider a possibility of reticulum cell sarcoma of the brain.
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PMID:[A case of primary reticulum cell sarcoma of the brain with uveitis (author's transl)]. 76 82

Frequently the first clinical sign of neuroblastoma is not caused by local or metastatic tumor growth but is a paraneoplastic symptom (PNS). Such PNS are fever, diarrhea, hypertension, weakness of muscles, Horner's syndrome and myoclonic encephalopathy. Certain PNS disappear with tumor removal, other do not. The clinical importance of PNS is the prognostic and especially diagnostic value. The pathogenetic relations between tumor and PNS as discussed in the literature are interesting but mostly speculative. Effects of Catecholamines and/or immunologic reactions are thought to be the most probable cause of PNS.--The article is based on current literature; in addition, two short case histories are presented.
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PMID:[Paraneoplastic symptoms of neuroblastoma (author's transl)]. 77 98

Malignant disorders may produce neuromuscular syndromes in a variety of ways, for some of which it is still difficult to determine the exact pathophysiology. In the myopathic and neuropathic disorders, one possible explanation is that they are due to a virus such as is found in the rare "progressive multifocal leukoencephalopathy". This is seen in association with the malignant lymphomas and with other conditions such as sarcoidosis where immune responses may be altered by either the disease or the treatment. No viral material has been found in the nonmetastatic neurological disorders apart from progressive multifocal leukoencephalopathy. An alternative theory is that there may be an autoimmune process, the nervous system sharing some antigenic determinant with the neoplasm (Urich, 1967). The prognosis in the paraneoplastic neurological disorders is usually poor. As well as the direct threat to life posed by the malignant disease, when the neurological disorder is due to destruction of neurones (for instance cerebellar degeneration or sensory neuronopathy) recovery of function is impossible. Spontaneous remissions have been recorded in cases of proximal muscle weakness and sensorimotor neuropathy, but it is difficult to know whether the remissions have been truly spontaneous or related to treatment (excision of the neoplasm or administration of steroids). Further immunological and virological studies will probably reveal the answers to some of the outstanding problems. In the meantime the clinician must continue to investigate patients with muscular weakness for evidence of an occult neoplasm, and to repeat investigations if no other cause for the neurological disorder is found. Also, in patients with known malignant disease, apart from trying to differentiate forms of neuromyopathy from the effects of metastases the various metabolic disorders must be considered because the therapeutic possibilities are a little more promising in the paraneoplastic endocrine disorders. Ross (1975) wisely said that "cancer has replaced syphilis as the great imitator".
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PMID:Neuromuscular syndromes associated with malignant disease. 85 66

A partial review of selected published case reports of AD-P associated with malignancy has been enhanced by the presentation of pertinent data on 15 unreported examples of the association. It is noteworthy that the first case in current literature of AD-P associated with a malignancy was described in 1916. The brief clinical report of a patient with proximal muscle weakness and skin lesions, with the obvious association with a malignancy (adenocarcinoma of the stomach), describes an example that has been repeated many times with different types of tumors but with essentially no variations in the clinical findings. In 1959 Williams identified 590 cases of AD with an overall tumor rate of 15%, and recently Barnes identified 258 cases of AD associated with a malignancy. The original designation, dermatomyositis or AD, has now been expanded to include proximal muscle polymyositis with systemic involvement, which syndrome at the current state of the art is indistinguishable clinically and pathologically from AD except for the lack of skin lesions. It may be that at some future time one or more immunologic features may differnetiate the clinical entity polymyositis from AD and further subdivide each of these entitites from similar clinical syndromes associated with a malignancy. However, the problem in management in either AD or polymyositis is similar. A number of patients with a malignancy and muscle weakness or neuropathy have been reported. These associations have been mentioned briefly, but insufficient data are available to determine whether these should be considered as a variant of AD-P or only casually related conditions with certain clinical features in common. Most of the patients described in the literature of AD-P with an associated malignancy have had skin lesions; a minority only have lacked this feature. However, unless a patient is followed carefully, it is possible for a transient or evanescent erythema or insignificant skin lesions to be present and not recorded in the case record.
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PMID:Acute dermatomyositis-polymyositis and malignancy. 85 19

Since 1947, we have treated 19 children with neuroblastoma whose first symptoms were paralysis or weakness of an extremity, and/or incontinence due to tumor in the spinal canal. In 18 patients, the spine tumor was part of a dumbbell tumor which was present in the adjacent paravertebral area and in one, no extraspinal tumor was found. Aggressive treatment was employed for all. In 17 children, the intraspinal tumor was treated by laminectomy and irradiation with and without chemotherapy. Radiation and chemotherapy were used for two. The extraspinal tumor was excised totally in six and partially in six. All 12 children received postoperative radiation and chemotherapy. In 6 children, the extraspinal tumor was treated only with radiation and chemotherapy. Nine of 19 children are alive without evidence of neuroblastoma. Thirteen patients showed either partial (6) or full (7) neurologic recovery. Survival was related to the child's age at diagnosis and the extent of disease. While 8 of 9 children under 1 yr of age survived, only 1 of 10 children over 1 yr survived. None of the 5 children with Stage IV disease at diagnosis could be saved. The degree and frequency of neurologic recovery were greatest in children whose neurologic symptoms had been present the shortest times and were equal among those who survived and those who died. The outlook for children who became paralyzed by neuroblastoma is not hopeless; therapy aimed at saving life or neurologic function is both worthwhile and rewarding.
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PMID:Prognosis for children with neuroblastoma presenting with paralysis. 87 30

Increased intracranial pressure and papilledema are occasionally observed in patients harboring spinal tumors in the cervical region or at the craniocervical junction, and the mechanical obstruction to the cerebrospinal fluid circulation is assumed to be responsible for such symptoms and signs. However, increased intracranial pressure is very rare in spinal tumors locating in the dorso-lumbar region; only 44 such cases having been reported in the literature. Recently we saw a 58-year-old female who presented with three brief episodes of loss of consciousness associated with nausea and vomiting, progressive dementia and insomnia. Neurologic examination disclosed an early papilledema, weakness of both legs and dementia. A left carotid angiogram revealed a small aneurysm arising from C2 segment of the internal carotid artery. Right carotid and bilateral vertebral angiograms were not contributory. The aneurysm was clipped at the first operation. The aneurysm was found apparently unruptured. A ventriculoperitoneal shunt failed to improve her dementia. Finally, a total myelographic block was found at L1 level, and a neurinoma arising from the right D12 was removed. After this, all symptoms and signs disappeared within 3 weeks. Pertinent literature on the low spinal cord tumor associated with an intracranial pressure was reviewed and the mechanism of the elevation of intracranial pressure in such cases were discussed.
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PMID:[Thoraco-lumbar spinal tumor associated with papilledema (author's transl)]. 91 17

The microscopic characteristics of a 0.9 cm vestibular schwannoma en bloc resected with its nerve of origin which occurred in a 54-year-old white woman presenting with a two-year history of a unilateral progressive sensori-neural hearing loss is described. The tumor originated in the inferior vestibular portion of the vestibular division of the VIIIth cranial nerve just medial to the internal auditory canal meatus at approximately the level of the glial-non-glial junction. The tumor demonstrated two distinctly different, yet simultaneous, modes of involvement with its nerve of origin: 1. inseparable cellular continuity; and 2. peripheral compression of the remainder of the nerve within the tumor capsule. Despite only slight microscopic continuity of the nerve histologically, electronystagmography showed no unilateral weakness on bithermal caloric testing, and pure tone and speech audiometry was only moderately depressed.
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PMID:Microscopic characteristics of the acoustic tumor in relationship of its nerve of origin. 93 94


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