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

An unusual presentation of Leigh's disease consisting of rapid progression of leg weakness in a young child is discussed. Magnetic resonance imaging revealed an intramedullary mass lesion of the conus medullaris. Surgical exploration revealed only necrosis and inflammation. Subsequent studies revealed pathology in the cerebrum as well as the spinal cord. Metabolic abnormalities confirmed the diagnosis of Leigh's disease. The differential diagnosis of intramedullary mass lesions demonstrated by magnetic resonance imaging should include metabolic, inflammatory, and ischemic processes as well as neoplastic disease.
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PMID:Leigh's disease presenting as an intramedullary mass lesion. 158 94

To determine if recent trends in evaluation and therapy have contributed to the successful surgical management of carotid body paragangliomas, we reviewed our experience over the past decade. Nineteen carotid body paragangliomas were identified in 17 patients. Eleven patients underwent complete, preoperative embolization of their afferent arteries with one complication. Calculated carotid body paragangliomas surface areas did not differ between the embolized 64.6 +/- 43.3 cm2 and nonembolized 63.0 +/- 57.9 cm2 lesions. Intraoperative blood loss was lower (p = 0.02) in the patients treated with embolization (372 +/- 213 ml) compared with their cohorts (609 +/- 564 ml). However, the operative times were equivalent 4.1 hours versus 4.5 hours in both groups. Intraoperative electroencephalographic (EEG) monitoring was used in 10 patients; in one patient the EEG indicated intraoperative thrombosis of the carotid artery, which was successfully treated by thrombectomy without complications. Two patients required carotid bifurcation resection and vascular reconstruction to remove the entire tumor; a late stroke manifested by contralateral hand weakness developed in one of these patients. The incidence of cranial nerve injury was low at 16%, with one transient ramus mandibularis paresis and two instances of vocal cord dysfunction. Two additional patients had a postoperative Horner's syndrome. We conclude that by diminishing intraoperative blood loss through complete and careful preoperative embolization and use of intraoperative EEG monitoring along with careful surgical technique, the complications associated with this challenging operation are facilitated and diminished.
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PMID:The current surgical management of carotid body paragangliomas. 159 86

An 83-year-old lady was admitted for bilateral pain and weakness of the shoulder and hip girdles. These symptoms suggested a Polymyalgia rheumatica (PMR) but there was no response to corticosteroids. A pulmonary adenocarcinoma without any metastasis was then diagnosed. The excision of this tumor was followed by prompt and complete recovery. The erythrocyte sedimentation rate became normal within a few days, also. Such an issue seems to prove that PMR may occasionally be associated with neoplasia. This association appears anecdotal in the literature and remains without clear explanation.
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PMID:[Polymyalgia rheumatica and pulmonary cancer: paraneoplastic syndrome]. 160 29

Recent data suggest that prognosis is similar for women with primary breast cancer whether they receive modified radical mastectomy (MRM) or local excision and axillary dissection with radiation (XRT). The effects of either of these treatments on arm mobility, pain, or edema have not been compared. To assess the impact of MRM or XRT on mobility, pain, or edema, we evaluated patients treated in a prospective randomized trial designed to assess prognosis following MRM or XRT. All were provided a standardized physical therapy program including arm mobilization, shoulder strengthening, prevention and treatment of upper extremity edema, and education about arm function. Patients were evaluated for chest wall pain, arm motion, muscle strength, and edema as determined by circumferential measurements at the wrist, forearm, and arm. Evaluations were performed preoperatively and at yearly anniversaries of their surgery. Women receiving XRT had more chest wall tenderness at 1 and 2 years after surgery than those receiving MRM (p2 less than 0.0001 and p2 = 0.0007 respectively). Those receiving MRM were slower to reach their preoperative range of motion (ROM) (p2 = 0.043). Incidence of muscle weakness was similar in both groups. The few patients with local recurrence of tumor had more upper extremity edema than those who did not recur (p2 = 0.085) at 1 year and (p2 = 0.02) at 2 years. In patients who did not develop local recurrence, those who had received XRT had greater but nonsignificant increases in upper extremity circumferential measures compared with those receiving MRM at any anniversary evaluation. Patients receiving MRM and XRT are likely to have some differences in functional outcome.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of pain, motion, and edema after modified radical mastectomy vs. local excision with axillary dissection and radiation. 162 17

We report a rare case of germinoma with granulomatous reaction arising from the corona radiata. This 20-year-old man was admitted to our hospital complaining of progressive motor weakness on the right side. CT demonstrated a poorly demarcated high density area in the left corona radiata, which was heterogeneously enhanced after administration of contrast medium. Moreover, the continuity of the mass to the ventricular wall was confirmed on MRI. At the first operation, subtotal removal of the tumor was performed through a fronto-parietal craniotomy. The diagnosis for the specific neoplasm was not established histologically, but granuloma caused by fungal infection was the most likely cause of the lesion. We tried amphotericin B (AmB), and remission of the tumor was obtained. However, during the following 3 months, the size of the tumor gradually enlarged again. AmB was repeatedly administered, but this time the treatment was ineffective. Six months later, on May 21, 1990, the second operation was performed and histological examination revealed typical germinoma consisting of two-cell pattern. Subsequently, the patient underwent focal irradiation of 33 Gy to the tumor site, and the tumor completely disappeared. As intracranial germinomas are observed to be successfully cured by radiotherapy and/or chemotherapy, choice of the therapeutic management must be carefully determined according to the histological diagnosis, especially in young people. A variety of locations of germinomas and the accompanying granulomatous reactions could create some diagnostic confusion, so great care must be taken in the treatment of much intracranial germinomas.
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PMID:[Germinoma with granulomatous reaction arising from the corona radiata; case report and review of articles]. 163 May 69

Resection of tumors of the posterior cranial base may incorporate a segment of the facial nerve because of tumor infiltration, or may result in unplanned nerve injury. Immediate repair of the facial nerve by resuture or with an autogenous nerve graft is highly desirable to ensure optimal recovery of facial function. Twenty-four patients who underwent extensive surgery of the posterior skull base and facial nerve reconstruction were studied. Of these, 12 patients had preoperative facial weakness and 3 had facial palsy. All patients underwent graft reconstruction from the subarachnoid or labyrinthine portion of the facial nerve to the fallopian or extracranial segment. The greater auricular nerve was used as a graft in 14 patients, and the sural nerve in 10. Two patients died of their disease soon after surgery, and, therefore, were excluded from our follow-up. In the remaining 22 patients, the median follow-up time was 20 months. As evaluated by the House-Brackmann grading system, 45% (10/22) of the surviving patients achieved a good recovery of facial function, 36% (8/22) attained a fair recovery, and 18% (4/22) had minimal or no recovery. There was no statistical correlation between the length of the graft used and the degree or timing of clinical recovery. The surgical result obtained in all patients with complete preoperative facial palsy and in one patient with dense facial paresis was poor.
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PMID:Facial nerve repair by interposition nerve graft: results in 22 patients. 164 Nov 12

A case of 55-year-old man pathologically proven as neoplastic angioendotheliosis was reported. He initially developed sensory disturbance and motor weakness in the lower extremities. After admission, he showed progressive deterioration of higher brain functions with moderate fever. Routine laboratory examinations revealed elevated serum LDH level and erythrocyte sedimentation rate without leukocytosis or increased serum globulin level. Immunological tests were normal, except positive RA. Immunocytochemical investigation of tumor cells in the blood vessel gave the results that these cells appeared to be derived from B cells. Southern blot analyses of the brain samples revealed clear positive bands corresponding to JC virus DNA in the blot. JC virus has been known to infect the endothelial cells of the blood vessel as well as urethral epithelial cells. We discussed the possible mechanism of the selective growth of tumor cells in the blood vessel in terms of possible JC virus infection to the endothelial cells of the blood vessel and abnormal recognition between tumor cells and endothelial cells.
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PMID:[A case of neoplastic angioendotheliosis--possible mechanism of JC virus infection for the selective growth of tumor cells in the blood vessel]. 166 71

A boy, 9 years, 8 months of age, with hairy pigmented nevi over the trunk, upper extremities, and face with bone deformities characteristic of rickets was admitted because of general weakness and poor appetite for 3 weeks. Repeated examinations demonstrated marked brainstem dysfunction; a brainstem tumor was visualized by computed tomography. The patient died 14 days after admission despite supportive treatment. The relationship between giant intradermal nevocellular nevi and brain tumor is discussed.
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PMID:Giant nevocellular nevi with rickets and brainstem tumor. 166 93

Ipsilateral brain atrophy is rare in neoplastic lesions of the brain, but it has been reported in patients with a thalamic tumor. We report a Chinese boy who presented with a right focal motor seizure and right side weakness at the age of six and half years when an electroencephalogram (EEG) showed focal epileptic discharges over the left hemisphere, but computed tomography (CT) of the brain failed to reveal a definite mass lesion. The weakness became gradually worse. On admission at age 8, follow-up CT scan revealed a huge tumor (5 x 5 x 7 cm) compressing the third and lateral ventricles with mixed densities in the left thalamus and centrum semiovale. The scan after contrast infusion showed a marked enhancement of the tumor. Instead of peri-mass edema surrounding the tumor, the overlying cerebral tissue showed atrophy of the ipsilateral cortical layer. He received subtotal resection of the tumor. The pathology proved to be germinoma. A test of tumor markers revealed a high human chorionic gonadotrophin level in the blood and cerebrospinal fluid. A short course of radiotherapy and chemotherapy was given after surgery. He has been well for the past two years.
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PMID:[Unilateral thalamic tumor with atrophy of ipsilateral cortical cortex: report of a case]. 168 Oct 9

A recurrent lumbo-sacral chordoma with high-grade cartilaginous and spindle cell components is described. The tumor was excised from a 71-year-old man who previously had a conventional chordoma resected from his sacrum 26 years earlier. The original conventional chordoma was treated postoperatively with external beam radiation therapy, and the patient was free of disease until he presented at the age of 71 with leg weakness. Computerized tomography revealed a lumbo-sacral soft tissue mass. This was excised and found to have three distinct histologic aspects. The largest component was that of a conventional chordoma. The second component consisted of islands of malignant cartilage intimately admixed with the cells of the conventional chordoma. The third component consisted of high-grade malignant, poorly differentiated spindle cells. This case suggests that chondroid chordomas do exist and that they may also occur outside of the spheno-occipital region.
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PMID:Lumbo-sacral chordoma with high-grade malignant cartilaginous and spindle cell components. 169 Sep 55


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