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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Degenerative diseases of the lumbar vertebral discs or the vertebral joints are the main causes of low back pain and sciatica following overstraining during sports activities. However, they are rarely seen in sportsmen engaged in competitive sports because these persons are mostly young and well-trained. Other neurological diseases are even rarer as possible causes of sciatica. That is why we report on a young athletic who is a short-distance hurdler (110m hurdle race) and has been suffering from a neurinoma of the spinal nerve root L3 with sciatica and pain in the knee as initial symptoms. Attention is drawn to the importance of neurological examinations as part of medical examinations conducted by sports physicians for the purpose of obtaining an overall guiding picture of the subjects' health status.
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PMID:[Neurinoma of the L3 spinal nerve root as a cause of stress-induced lumbo-ischialgias]. 324 51

Retroperitoneal neurilemmomas are rare tumors. They are usually asymptomatic, and often become quite large before they are discovered. A case is reported of a 75-year-old man with complaints of general malaise and left lumbar pain. Intravenous pyelography showed left renal nonfunctional and retrograde pyelography revealed the stenosis of the left ureter. The ultrasonogram demonstrated a cystic mass, and it was diagnosed as a retroperitoneal tumor with central necrosis by computerized tomography and magnetic resonance imaging. The tumor was removed with the left nonfunctioning kidney and ureter. The tumor was 3 x 3 x 4 cm, and the histological diagnosis was neurilemmoma (Antoni A + B type). There was a tight fibrous adhesion between the tumor and the left ureter, and the tumor was concluded to have originated from the adventitia of ureter. To date, 120 benign cases have been reported in Japan. They are reviewed and discussed.
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PMID:[A case of paraureteral neurilemmoma causing ureteral obstruction: report of a case]. 329 87

Over a 17-year period, 56 patients with 57 tumors involving the brachial plexus were operated upon. The 40 neural sheath tumors included 26 neurofibromas, 8 schwannomas, 4 malignant neural sheath tumors, 1 fibrosarcoma, and 1 meningioma. Nine of the neurofibromas were associated with von Recklinghausen's disease (VRD), and 2 others were what was termed regionalized neurofibromatosis characterized by involvement of one limb with extension along the course of one or more plexus elements. Seventeen tumors were not of neural sheath origin; 7 were benign and 10 were metastatic malignant tumors compressing or invading the plexus. Benign neurofibromas and malignant sheath tumors almost always presented with pain or functional neural deficit, whereas schwannomas often presented with a palpable mass as their only initial symptom. Patients with solitary neurofibromas were significantly older, often female, and more likely to have tumor on the right side than patients with schwannomas, malignant neural sheath tumors, or neurofibromas associated with VRD. Solitary neurofibromas could often be totally resected without added deficit by sacrificing fascicles entering and leaving tumor that were determined to be "nonfunctional" by intraoperative nerve action potential recordings. Resection of neurofibromas associated with VRD sometimes but not always resulted in significant loss. Operation is nonetheless recommended, especially when malignancy is suspected because of rapidly increasing size, when severe pain or neural deficit is present, or when compression of adjacent plexus elements is a concern. Schwannomas and benign non-neural sheath tumors can usually be extirpated without damage to plexus elements. Forequarter amputation is advised for malignant intrinsic tumors involving distal plexus elements even though gross total resection seems feasible.
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PMID:Tumors of the brachial plexus. 331 5

A case of trigeminal neurinoma with marked extracranial extension is reported with a review of the literature. A 60-year-old female noticed numbness over the left side of the face during the proceeding 15 years. Two years prior to admission, she began to complain of itching and lancinating pain at the left lateral aspect of the nose. Neurologic examination on admission revealed diminished corneal reflex on the left side and hypesthesia in the distribution of the left trigeminal nerve. There was no weakness or atrophy of the ipsilateral masticatory muscles. The remaining cranial nerves and cerebellar functions were normal. Craniograms showed destruction of the left petrous apex, enlargement of the left superior orbital fissure and an extensive bone defect in the floor of the left middle cranial fossa. CT disclosed a huge heterogeneously enhancing mass lesion in the left middle cranial fossa, which extended posteriorly into the left cerebellopontine angle and inferiorly into the pterygoid and infratemporal fossae. Cerebral angiograms revealed medial displacement of the left internal cerebral artery in the ganglionic, cavernous and supraclinoid portions, and elevation of the left middle cerebral artery in the sphenoidal portion. Although the left meningohypophyseal trunk was dilated, no tumor stain was observed. A transantral biopsy specimen provided the diagnosis of neurinoma with Antoni type A tissue. The patient was followed up at the outpatient clinic as radical operations were not agreed upon. Eight cases of trigeminal neurinoma with extracranial extension are reviewed including the presented case. There were two males and six females, and the age varied from 16 to 65 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of trigeminal neurinoma with marked extracranial extension]. 332 32

The case of a 52-year old patient is described who was operated on for pronator-teres syndrome. Eight months postoperatively reoperation was necessary because of recurrent pain. The median nerve showed haemorrhagic necrosis in the region of the pronator teres muscle with an extensive intrafascicular swelling of the adjacent proximal and distal nerve segments. After resection of the median nerve, the histological examination revealed a benign schwannoma. Reconstruction of the median nerve was performed by interfascicular nerve grafting. Three months later severe pains recurred in the forearm which had to be opened in an emergency operation. Extensive haemorrhagic necrosis was evident. The histological diagnosis was now malignant schwannoma. Upper arm amputation was performed and later a functional prosthesis was fitted. Three years after the amputation multiple metastases occurred; the patient died within three months.
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PMID:[Malignant schwannoma of the median nerve]. 340 42

A retrospective study of 88 cases of extraskeletal osteosarcoma revealed that this tumor affects adults almost exclusively, with a high incidence in patients older than 50 years, and is slightly more common in males (58%) than in female patients. The tumor occurred principally as a soft tissue mass in an extremity, with a predilection for the thighs (lower extremity, 46.6%; upper extremity, 20.5%) and the retroperitoneum (17%). Most were deep-seated and were firmly attached to the fascia, but occasionally they were freely movable and confined to the subcutis or dermis. Nearly all presented as an insidiously growing mass rarely causing pain or tenderness. The preoperative duration of symptoms ranged from 2 weeks to 25 years (median, 6 months). In 17 cases, it exceeded 2 years. A history of prior trauma to the site of the tumor was stated in 11 of the 88 cases (12.5%) and of radiation in five cases (5.7%). Microscopically, the tumors contained varying amounts of neoplastic osteoid and bone, sometimes together with islands of malignant-appearing cartilage. Like osteosarcoma of bone, extraskeletal osteosarcoma showed a striking variation in histologic appearance and focally resembled malignant fibrous histiocytoma, fibrosarcoma, and malignant schwannoma. Follow-up information was available for 65 patients. Eight (12.3%) patients were alive with no evidence of recurrence; 12 (18.5%) patients were alive with one or more recurrences; and five (7.6%) were alive with metastases. Twenty-eight of the tumors (43%) recurred and 39 (63%) metastasized. Forty (61.5%) of the patients with follow-up information had died, 36 from the tumor and four from miscellaneous causes. The prevailing sites of metastases were the lung, the regional lymph nodes, and bone.
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PMID:Extraskeletal osteosarcoma. 347 57

A case of trigeminal neuralgia caused by a contralateral acoustic neurinoma is reported. The patient's tic pain was completely alleviated after removal of the tumor. Previously reported cases of trigeminal neuralgia caused by contralateral cerebellopontine angle tumors are reviewed, and the pathophysiology of this disorder is discussed.
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PMID:Cerebellopontine angle tumor causing contralateral trigeminal neuralgia: a case report. 349 59

2 cases of spinal subarachnoid hemorrhage due to tumors of the cauda equina are reported. In both cases the existence of cephalic meningeal signs first suggested an intracranial pathology and diagnostic procedures were performed in this direction. Only when these examinations were negative was a lesion of the cauda equina suspected. The lesion was located by myelogram and was diagnosed, after surgical removal, as a schwannoma and an ependymoma. The syndrome of spinal subarachnoid hemorrhage involves spinal symptoms and signs resembling violent lumbar and radicular pain with a hemorrhagic cerebrospinal fluid, in association with symptoms of intracranial origin such as headache and meningism. Lumbar and radicular pain preceding the headaches, and an unaltered level of consciousness, point to the rare syndrome of spinal subarachnoid hemorrhage.
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PMID:[Spinal subarachnoid hemorrhage. Apropos of 2 cases of cauda equina tumors]. 372 10

Thirteen cases of giant sacral schwannomas with erosion of the anterior aspect of the sacrum and associated intrapelvic extension are reviewed. These tumors showed no sex predilection; the patients' mean age was 38.6 years at the time of diagnosis, and their symptoms predated the diagnosis by an average of 5.2 years. The most common symptoms were low-back pain and lower-extremity dysesthesiae. Plain roentgenograms, myelography, and computerized tomography constituted essential and complementary studies in the preoperative assessment. Choice of surgical approach (anterior transabdominal vs. posterior transsacral) was dependent upon the amount of sacral destruction, intrapelvic extension, and sacroiliac joint involvement. Microscopic examination revealed classic features of benign schwannoma in all but three cases, which were classified as cellular schwannomas. Patients who presented with pain and dysesthesiae reported immediate and complete relief of symptoms following surgery. In addition, all 13 patients were ambulatory and able to resume their routine daily activities postoperatively. At the last reported follow-up examination, which ranged from 5 months to 33 years and 3 months (mean 9 years) after surgery, two patients had died of unrelated causes, two reported return of preoperative symptoms, and the remainder were asymptomatic. This experience suggests that these histologically benign but neurologically devastating tumors should be aggressively resected with the intent of complete extirpation, and that this goal may be accomplished with minimal risk and an excellent prognosis.
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PMID:Surgical management of giant sacral schwannomas. 373 78

Sixty-seven cases of sarcomas and sarcomatoid neoplasms of the major salivary gland regions were studied in order to determine the clinical and histomorphologic features and biologic behavior. Fifty-seven of these proved to be sarcomas and the two most common types were malignant schwannoma (11) and fibrosarcoma (9). Nine sarcomas could not be subclassified morphologically. Ten cases, originally believed to be sarcomas, proved by means of immunohistochemistry to be either carcinomas (five cases) or melanomas (five cases). Fifty-nine of the 67 cases occurred in the parotid gland regions, and the remaining eight occurred in the submandibular regions. Twenty of the 67 cases were thought to arise from within the gland, nine from paraglandular tissues, and insufficient data was present to anatomically categorize the other 38 cases. The mean age of occurrence was 42 years for men and 38 years for women. A swelling was the presenting symptom in 64 cases, with a mean duration of 4.3 months. Pain, tenderness, or paralysis were noted in 17 cases, but the swelling was painless in seven cases. Follow-up data of 42 sarcoma patients revealed that 17 experienced recurrences, 16 developed metastases, and 15 died of disease. These rates were lowest among patients with tumors arising from within the gland (Group I) and highest among those patients with tumors of paraglandular origin (Group III). Mean survival time for those dying of disease was 2.4 years, and a 5-year survival time appeared to be a significant indicator of cure. The most successful therapy was either parotidectomy (superficial or total) or a combination of surgery and radiation. The morphologic and the immunohistochemical evidence suggest that the majority of the tumors represent true sarcomas that may arise from undifferentiated pluripotential cells, but that the remainder (15%) represent epithelial malignancies.
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PMID:Sarcomas and sarcomatoid neoplasms of the major salivary gland regions. A clinicopathologic and immunohistochemical study of 67 cases and review of the literature. 374 55


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