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

Twelve cases of benign extramedullary tumors in the high cervical region and at the foramen magnum were experienced during past five years among eighty all spinal and paraspinal tumors. The diagnosis of masses in this region is very difficult because of the variety of clinical course, symptoms and neurological findings as pointed out by many reporters. Also in our cases, 70% of the patients complained of the deteriorated motor weakness of the upper or lower extremities on admission, though they had noticed the onset of slight neck or occipital pain a few years ago. Neurological examination on admission clearly showed the symptom of myelopathy except in two cases with a tumor at the foramen magnum and C1 level. The percentage of positive findings of plain X-rays was 50%, that of metrizamide myelography was 92% and that of IV. e. CT and met. e. CT was 100%. NMR-CT was performed in 2 cases, and in one of them it was useful in confirming the tumor configuration and extension. Five interesting cases were described mainly from the neuroradiological aspects. Finally the differentiation between meningioma and neurinoma was discussed from the aspects of myelogram, CT and NMR-CT. As already pointed out, it is most important not to forget the existence of tumors in this region when one comes across the confused symptoms, afterwards not to overlook the slight positive neurological and neuroradiological findings.
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PMID:[Neuroradiological evaluation of benign extramedullary tumors in the high cervical region and at the foramen magnum]. 376 52

A 40-year-old woman had pain and numbness in the left upper extremity, on Dec. 1982. These symptoms progressed gradually. She was admitted to our department on Jan. 26, 1984 because of neck pains and progressive paraplegia. Neurological examination revealed monoplegia of the left arm with absent DTRs, spastic paraplegia, sensory disturbances below Th 11 level and severe sphincter disturbance. A metrizamide myelogram showed intradural extramedullary mass at C 4-7. Laminectomy was immediately performed from C 3 to C 7. A soft and brown tumor was attached at the ventral aspect of the cord at C 3 and C 7 and it was firmly attached at the root sleeve of the C 5 level. The histological diagnosis of the tumor was malignant schwannoma. One month later, she was discharged on foot. However, she was re-admitted to our department because of intractable pains in left neck and arm in Aug. '84. The second operation was done on Sept. 15. A soft and brown mass was found intra- and extradurally and it invaded into paravertebral muscules. On Sep. 30 '84 she died from respiratory failure. Postmortem examination revealed that intra-extradural tumor was found at C 4-Th 3, and the left brachial plexus was swollen. In the brachial plexus, the nerve fiber was replaced with tumor in the perineurium. The tumor invaded to the vertebral body and the paravertebral muscles. There were numerous metastasis of the tumor in both lungs. The tumor was formed by variable and scanty cytoplasm with many mitotic figures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[An autopsy case of malignant schwannoma in the brachial plexus extending into the spinal canal]. 379 Mar 59

Neurilemomas of the cauda equina can present with a clinical syndrome indistinguishable from an acute prolapsed lumbar intervertebral disk. There is backache and sciatica, occasionally after trauma, and straight leg raising is usually limited with signs of L-5 or S-1 root compression. The only distinguishing clinical characteristic is that the pain is worse on recumbency and relieved by sitting or walking. There may be no plain x-ray changes for many years and the tumor is usually at the level of L-2 or L-3 vertebral body. Seven such cases are described in this report.
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PMID:Neurilemomas of the cauda equina presenting as prolapsed lumbar intervertebral disks. 396 15

A 64-year-old female visited Kawatetsu Chiba Hospital complaining of left retro-orbital pain. A month before, she had experienced ptosis and diplopia, that had been releaved two days later by corticosteroid. On admission, she had no neurological deficits except for minimal anisocoria, with the left pupil larger than the right. There was no cutaneous manifestation of von Recklinghausen's disease. Skull X-ray films showed depression of the floor of the sella turcica on the left side. CT scans demonstrated a parasellar enhancing mass with intrasellar extension. Left carotid angiogram showed intracavernous portion of the internal carotid artery displaced laterally, inferiorly, and anteriorly. With a tentative diagnosis of laterally extending pituitary adenoma, a transsphenoidal operation was carried out, which disclosed a solid tumor locating beside the medially-displaced pituitary gland. The histological diagnosis was typical neurinoma. Parasellar neurinoma is not so common. It is usually difficult to determine the origin of the parasellar neurinoma. Trigeminal neurinoma arising from the Gasserian ganglion is generally recognized to be the most frequent. However, the absence of the trigeminal nerve involvement, unusual CT findings, and angiographical changes in the present case were all different from those of the typical trigeminal neurinoma. We believe that the tumor of this case originated from the oculomotor nerve. Fifteen cases of neurinoma of the oculomotor, trochlear, and abducens nerve have been reported to date. Their clinical features were reviewed.
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PMID:[Neurinoma with intrasellar extension: a case report]. 398 98

A 63-year-old female visited our department, complaining of miction pain. She had several episodes of urinary occult blood. Urinalysis included a small number of red cells, white cells and bacilli. Physical examination revealed a fist-sized mass of her right flank. Cystoscopic examination showed a botryoid tumor with multiple erythematous raised plaques. Biopsy was reported as massive infiltration of eosinophiles in submucosal layer of the bladder, i.e. eosinophilic cystitis. Antibiotics were effective for the improvement of urine findings and symptoms within a week. IVP and CT revealed the abdominal mass as a retroperitoneal tumor with cystic degeneration, and the tumor was resected. Pathological diagnosis was benign neurinoma. Both eosinophilic cystitis and retroperitoneal neurinoma are rare, and the concurrent occurrence of these two diseases has not been reported. Recent studies have suggested that eosinophilic cystitis may occur more frequently than suspected, and may be overlooked clinically and microscopically. This uncommon form of cystitis should be considered in the differential diagnosis especially when the patient has unexplained episodes of bladder symptoms and hematuria.
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PMID:[A case of eosinophilic cystitis with retroperitoneal neurinoma]. 409 Nov 42

Sixteen cases of malignant peripheral nerve tumors that were recorded in the files of the Department of Orthopedics, National Cancer Center Hospital, Tokyo, between 1972-July 1983 were studied clinicopathologically. The patients' ages ranged from 24-51 years, and both sexes were affected equally. Histologically, in 13 cases of nerve sheath tumors the tumors were spindle-cell type, two of these patients had manifestation of multiple neurofibromatosis (von Recklinghausen's disease). One malignant epithelioid schwannoma was found to arise from the tibial nerve. Other two cases were of primitive neuroectodermal tumors (primary malignant peripheral neuroblastoma) which showed rosette formation. The common primary symptoms in all patients were a noticeable mass which increased in size over a variable period of time, with or without associated pain and tenderness. Ultrastructural findings of spindle-cell type (in 7 tumors examined) and epithelioid type (1 tumor) showed evidence of Schwann cell differentiation of the tumors in all cases. Immunohistochemically, by the PAP method (Sternberger), staining for S-100 protein was positive in 3 of 14 tumors. Ultrastructural findings in two S-100 protein-positive cases showed evidence of Schwann cell differentiation better than the S-100 protein-negative cases, such as pronounced interdigitation of cytoplasmic processes, presence of fibrous long-spacing collagen and well-developed basal lamina. Local recurrence occurred in nine patients, and metastasis was found in five. The total 5-year survival rate was 58.5%. Tumors associated with multiple neurofibromatosis and primary peripheral neuroblastomas had the worst prognosis. Complete removal of the tumor by means of wide excision as primary treatment seemed to be the most important factor in decreasing the morbidity and mortality rates.
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PMID:Malignant peripheral nerve tumors: a clinicopathological and electron microscopic study. 642 67

Thirty-five cases of neurogenic sciatic nerve tumors are described. Pain is the major clinical manifestation but may give rise to diagnostic confusion because of its often prominent site far distant from the neoplasm. Nonpalpable tumors are best identified by computed tomographic scan of the pelvis and thighs. Early surgical therapy is advisable. Neurilemomas are treated by simple enucleation with preservation of the sciatic nerve. They rarely recur. For neurofibromas, total excision is often not possible. As long as they are small and neurologically nondestructive, subtotal excision with preservation of the nerve trunk is recommended. When they are large or have caused marked neurologic dysfunction, radical tumor and nerve resection is required. In the usually highly malignant neurofibrosarcomas, disarticulation of the hip joint or hindquarter amputation affords the best chance for cure and should not be delayed once the diagnosis has been established.
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PMID:Neurogenic tumors of the sciatic nerve. A clinicopathologic study of 35 cases. 662 Nov 4

A case of giant intrasacral schwannoma is reported. This tumour was revealed by a lumbosacral pain without any neurological deficit. It appears that the lesion is surrounded by a dense layer of nucleated cells which resemble immature cells. This corona of young cells could explain the tremendous size of this tumour.
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PMID:A giant intrasacral schwannoma revealed by lumbosacral pain. 670 Aug 17

A 37-year-old man with complaints of lassitude and slight lumbal pain, who had been found to have a low abdominal median mass and was referred to our hospital by a practitioner, was admitted for further examination. IVP, examination of the gastrointestinal tract by the oral procedure and re-examination of the colon by a double contrast procedure revealed deviation of the right ureter, the urinary bladder and the alimentary tract. This mass was found to be a retroperitoneal tumor with central necrosis by low abdominal CT scanning and the low abdominal echography. The mass was removed easily, though it was slightly adherent to the anterior surface of the sacral bone. Pelvic lymphadenectomy was also done simultaneously. The removed mass was encapsulated by fibrous tissue, round in shape, 750 grams in weight (13 by 12 by 12 cm), evenly flat, elastic soft and contained 230 ml bloody exudate at the center. Histologically this mass contained areas where oval and spindle cells made palisading arrangement and areas where the tumor cells had no communication with each other and stroma was edematous. However, hyperchromatism of nuclei of tumor cells and high cellularity indicated this mass to be a malignant Schwannoma. Dissected lymph nodes had no metastatic involvement. Since the surgical margin was detected to be invaded by tumor cells, postoperative prophylactic irradiation of Linac (10 Me V-X, total doses 4,750 rads) was performed on the whole pelvis. This patient has been well and has had no signs of recurrence of tumor for 23 months after the operation. Ninety-four cases of benign retroperitoneal Schwannoma and thirty-six cases of malignant retroperitoneal Schwannoma reported in Japan are reviewed.
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PMID:[A case report of retroperitoneal Schwannoma]. 674 60

A trigeminal neurinoma which produced the signs and symptoms of a localized intratumoral hemorrhage without showing any extratumoral hemorrhage successive to a minor head injury is reported here. A 33-year-old man noticed pain and hypesthesia on the right side of the forehead and double vision on the day following an occipital trauma. A computed tomographic scan demonstrated a large high-density mass in the anterior part of the right cerebellopontine angle. A diagnosis of trigeminal neurinoma was made and the tumor was successfully removed. The largest part of the tumor consisted of a blood clot and necrotic tissue. In this case of minor head injury, the intratumoral hemorrhage was thought to have occurred as a result of obliteration of the lumen followed by recanalization of the meningeal vessels enclosed in the tumor by the growing neurinoma and distal vessel necrosis. Such a case of trigeminal neurinoma which revealed itself through intratumoral hemorrhage following a minor head injury has not been previously reported.
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PMID:Trigeminal neurinoma revealed by intratumoral hemorrhage following a minor head injury. 683 93


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