Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An unusual case of breast cancer metastatic to leiomyosarcoma of the uterus is reported. The patient had multiple metastases from the breast carcinoma and presented a pelvic mass in its evolution. A laparotomy with total hysterectomy and bilateral oophorectomy was performed to give pain relief. A review of the world literature about these uncommon sites of breast metastases is presented.
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PMID:Breast cancer metastatic to uterine leiomyosarcoma. A case report and review of the literature. 1280 52

Recurrent unbearable, paroxysmal, unilateral facial pain in the distribution of one or more branches of the trigeminal nerve often provoked by sensory stimuli is typical for idiopathic trigeminal neuralgia. The less frequent localization in the area of ophthalmic branch (5%) is particularly controversial and should be distinguished from pathological lesions in the brainstem and middle and posterior cranial fossa and from diseases of the orbit and eye. This case study presents a 79-year-old woman with typical clinical features of 1st division trigeminalgia without any neurological loss and with normal results of laryngological, ophthalmological, and stomatological examinations as well as neuroimaging CT, and MR /MRA evaluation. Only the evoked potential blink and masseter reflexes demonstrated the pathological values in the early phase of illness. After 1 year of pharmacological treatment no improvement was achieved and the pain became neuropathic and paresis of 3rd, 4th and 6th nerves developed, as observed in Tolose-Hunt syndrome. MRI of the orbit revealed a pathological mass in its apex with a connection to the superior orbital fissure. However, treatment with steroids was completely ineffective. Surgical resection of the tumor (leiomyosarcoma) only partially reversed oculomotor palsy and diminished aching. In differential diagnosis of idiopathic and symptomatic trigeminalgia, early MR and MRA imaging is the most essential and sometimes may be the best single test to evaluate lesions even in distant areas of the nervous system branches.
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PMID:Progression of preexisting trigeminalgia to Tolose-Hunt-like syndrome. The importance of neuroimaging for early differential diagnosis. 1465 50

A 72-year-old woman with von Recklinghausen's disease was referred to our hospital because of pain and muscle weakness in her thighs. She had elevated serum values of creatine kinase, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and aldolase. Based on these results, a diagnosis of polymyositis was made. Treatment with prednisolone improved muscle strength, and laboratory values returned to normal. Computed tomography, magnetic resonance imaging of the abdomen, and 131I-metaiodobenzyl guanidine MIBG scintigraphy demonstrated a tumor 3 cm in diameter in the region of the left adrenal gland. Endocrinologic investigation disclosed elevation of serum and urine catecholamines. Since the blood pressure was normal, nonfunctioning pheochromocytoma was diagnosed clinically. The nonhypertensive course was attributed to reduced vascular response to noradrenaline. Serum lactate dehydrogenase. alkaline phosphatase. and asparate aminotransferase became elevated, and abdominal computed tomography showed a well-defined mass measuring 13 x 12 x 10 cm in the right lobe of the liver. The patient underwent right trisegmentectomy and left adrenalectomy. Histologically the adrenal tumor was a typical pheochromocytoma. The hepatic tumor was a leiomyosarcoma consisting of elongated spindle-shaped atypical cells arranged in intersecting bundles. Immunohistochemically, the cells of this tumor were reactive for alpha-smooth muscle actin and vimentin. The leiomyosarcoma recurred and metastasized to the liver. Eight months after onset of symptom, the patient developed hepatic coma and died. The mean age at presentation with pheochromocytoma in von Recklinghausen's disease patients age is 42 years. Our patient was considerably older. To the best of our knowledge this is the first report of a patient with von Recklinghausen's disease developing polymyositis. asymptomatic pheochromocytoma, and primary hepatic leiomyosarcoma and illustrates the need to remain aware of the possibility of cancer in von Recklinghausen's disease.
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PMID:[A patient with von Recklinghausen's disease associated with polymyositis, asymptomatic pheochromocytoma, and primary hepatic leiomyosarcoma]. 1523 55

Uterine artery embolization (UAE) is an increasingly performed, minimally invasive alternative to hysterectomy or myomectomy for women with symptomatic uterine fibroids. A growing body of literature documents symptomatic improvement in the majority of women who undergo UAE. Although UAE is usually safe and effective, there are a number of known complications associated with the procedure. Major complications include fibroid passage, infectious disease (endometritis, pelvic inflammatory disease-tubo-ovarian abscess, pyomyoma), deep venous thrombosis, pulmonary embolism, inadvertent embolization of a malignant leiomyosarcoma, ovarian dysfunction, fibroid regrowth, uterine necrosis, and even death. Minor complications include hematoma, urinary tract infection, retention of urine, transient pain, and vessel or nerve injury at the puncture site. As UAE takes its place in the treatment arsenal for women with symptomatic fibroids, radiologists need to be familiar with UAE-associated complications, which may require further treatment and may even be life threatening in some cases. Knowledge of these complications and their imaging features should lead to prompt diagnosis and appropriate treatment.
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PMID:Imaging manifestations of complications associated with uterine artery embolization. 1622 86

We report the case of a young girl treated at age 16 for a progressive scoliosis by posterior instrumented arthrodesis. Ten years later, she suddenly developed lumbar pain and paraplegia. The surgical procedure showed a mass infiltrating the vertebral canal and the dural sheath following a supralaminar hook. Histology revealed a diagnosis of leiomyosarcoma. The outcome was poor with a rapid and fatal extension of the tumor. There is nothing to justify a causal link between the scoliosis and the late onset of a malignant tumor. Nevertheless, we discuss the potential role of diagnostic irradiation consecutive to scoliosis monitoring during growth and the potential role of environmental carcinogens like metallic biomaterials. Finally, rapid intrusion of this extraspinal tumor into the dural sheath resulted in a confusing clinical picture and delayed the diagnosis and treatment of the tumor.
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PMID:Late paraplegia after scoliosis treatment: an uncommon diagnosis. 1630 45

A 60-year-old woman was admitted to our hospital with pain in the left flank. Retrograde pyelography, computed tomographic scan, and magnetic resonance imaging demonstrated left hydronephrosis due to a 7 cm retroperitoneal mass involving the left ureter. Left nephroureterectomy and partial resection of the mesentery revealed a primary ureteral leiomyosarcoma. Three months postoperatively, the patient received systemic chemotherapy (CYVADIC; cyclophosphamide, vincristine, adriamycin and DTIC) for a recurrent tumor. Two courses of chemotherapy reduced the tumor by nearly 60%. Then we performed surgery in an attempt to resect the residual disease. However, the tumor continued to progress and the patient died approximately one year after diagnosis.
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PMID:[A case of primary leiomyosarcoma of the ureter]. 1647 89

Spermatic cord leiomyosarcomas are rare tumors and standard treatment consists of radical orchiectomy and high cord ligation. We report a case of a paratesticular leiomyosarcoma successfully treated by enucleation. A 22-year-old man presented with a 6-months history of inguinal pain. Physical examination revealed a right paratesticular nodule about 0.5 cm in diameter. Inguinal exploration and nodule biopsy were performed. It was thought to be a benign epididymal nodule on a quick section and the tumor was enucleated and sent for paraffin section. Histology and immunohistochemistry were compatible with leiomyosarcoma. The patient was advised to undergo radical orchiectomy with high cord ligation. However, he refused surgery. An alternative approach with clinical, biochemical and radiological follow-up was adopted. The patient has been followed up for thirteen years and shows no evidence of disease.
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PMID:Paratesticular leiomyosarcoma treated by enucleation. 1651 31

Adrenal myelolipoma is a rare, benign and biochemically inactive tumor. It is usually diagnosed incidentally by radiological methods and is known to be associated with obesity, hypertension, endocrinological disorders and some malignancies. We report herein the association of a myelolipoma with a gastrointestinal stromal tumor. To our knowledge this is the first report of such an association to date. A 67-year-old male patient admitted to our clinic with abdomimal pain and fever; he had a history of hypertension and diabetes mellitus. In physical examination, a mass involving the right quadrants was palpated. Computerized tomography revealed a right retroperitoneal mass, probably originating from the kidney or cecum. In laparotomy, the tumor (12 cm radius and 1500 g) localized on the superior of right kidney was excised. Abdomen exploration revealed another mass with 10 cm radius 100 cm distal to the ligamentum of Treitz and segmental jejunal resection and anastomosis were applied. The pathological diagnosis was reported as myelolipoma for the retroperitoneal mass and leiomyosarcoma for the jejunal mass. Myelolipoma is a benign tumor, involving mature fat and hematopoietic stem cells. Pathogenesis is still not clear and the microscopical characteristics are hematopoietic, lipoid, and reticuloid cells and megakaryocytes. Myelolipomas are reported to be associated with some other malignancies (especially renal), but this is the first report showing the association with a leiomyosarcoma. Therefore, leiomyosarcoma should also be one of the possible associations kept in mind by the physician in the diagnosis and treatment of myelolipomas.
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PMID:Giant adrenal myelolipoma associated with small bowel leiomyosarcoma: a case report. 1683 Feb 97

Authors treated a oesophageal sarcoma in a 46 year old female patient in July 1999. The tumor caused retrosternal pain and weight loss but did not disturb swallowing. After resecting the tumor, an intrathoracic oesophago-gastrostomy was performed. On the 18th postoperative day the patient went home without any complaints. Histologically the tumor proved to be a leiomyosarcoma. The patient has had no complaints in the past 6 years. On account of this case report the authors review the literature on this rare disease.
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PMID:[Leiomyosarcoma of the oesophagus: a case report]. 1743 85

Uterine inversion is a rare complication of the postpartum period, but it is an even rarer complication of the non-puerperal period. A 49-year-old nulliparous woman was admitted to the hospital with the following complaints: abnormal vaginal bleeding, pain, anuria and a mass protruding from the vulva. The mass was removed by twisting and a laparotomy was required for massive bleeding due to the inversion. The diagnosis of complete inversion was made during the laparotomy. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed and the pathological examination revealed a leiomyosarcoma. Uterine inversion in the non-puerperal period is an extremely rare event and it should be kept in mind that the cause of the inversion may be a malignant disease, like leiomyosarcoma.
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PMID:Non-puerperal inversion of the uterus caused by leiomyosarcoma: a case report and clinical management. 1757 77


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