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)

This report describes a case involving a 22-year-old pregnant woman with synovial sarcoma in the thigh. The patient recognized an elastic hard mass accompanied by a dull pain in the anteromedial portion of the right thigh. Magnetic resonance imaging delineated a deep soft-tissue mass measuring 9 x 7 x 6 cm. Histologic diagnosis of poorly differentiated synovial sarcoma was made based the results of an open biopsy. In this patient, the SYT-SSX fusion gene transcript was detected by nested polymerase chain reaction (PCR) in the peripheral blood collected before biopsy. Two months after wide local resection of the tumor, multiple lung metastases developed. This is the first reported case in which tumor cells were detected by nested PCR in the peripheral blood of a patient with synovial sarcoma. These findings suggest that circulating tumor cells should be monitored because they may serve as a prognostic indicator for synovial sarcoma.
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PMID:Detection of SYT-SSX fusion gene in peripheral blood from a patient with synovial sarcoma. 1122 13

The objectives of this study were to determine the prevalence of dyspnea in the general cancer population, the intensity of the symptom as perceived by the patient, and the patient characteristics associated with the presence of dyspnea. Nine hundred and twenty-three cancer outpatients completed visual analogue scales (VAS) and verbal rating scales (VRS-D) to assess the intensity of their dyspnea. Baseline data included variables that were known covariates of dyspnea. Forty-six percent of the patients had some shortness of breath. Only 4% had a diagnosis of lung cancer and 5.4% lung metastases. Risk factors found to be significantly related to the presence of dyspnea were history of smoking; asthma or chronic obstructive pulmonary disease (COPD); lung irradiation; or a history of exposure to asbestos, coal dust, cotton dust or grain dust (P values from 0.001 to 0.038). The prevalence of dyspnea was strongly related to the number of risk factors a patient had (P < 0.0001). The VAS and VRS-D were significantly correlated, establishing concurrent validity for the VRS-D.
J Pain Symptom Manage 2001 Feb
PMID:Dyspnea in cancer patients: prevalence and associated factors. 1122 61

Osteosarcoma shows a variety of histologic patterns. Rarely, this tumor may appear epithelioid, including a rosettelike configuration simulating glands. We retrospectively reviewed 16 cases of osteosarcoma with rosettelike structures treated at the National Cancer Center and Akita University, Japan, from 1972 to 1999. The 16 patients were under 30 years of age, and males were predominant in the sex distribution. The tumors arose primarily in the metaphysis of long tubular bones, and the most common symptom was pain. Roentgenographically, the lesions showed a highly destructive appearance with varying degrees of mineralization. Twelve patients (75%) died of multiple lung metastases in spite of surgery with wide surgical margins and systemic chemotherapy. The estimated cumulative 5-year survival rate was 15%, significantly worse than the rate of 55% in 70 cases of conventional osteoblastic osteosarcoma without rosettelike structures arising in long tubular bones. All of the 16 tumors, originally classified as conventional osteoblastic osteosarcoma, predominantly displayed a small multinodular growth pattern with lacelike osteoid deposits in the center between dilated blood vessels showing a hemangiopericytoma-like appearance. Ten tumors (63%) showed immunoreactivity for epithelial membrane antigen. We believe rosette formation in osteosarcomas of long tubular bones is an ominous sign; therefore, those tumors should be distinguished from osteosarcomas with conventional morphotypes.
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PMID:Rosette-forming epithelioid osteosarcoma: a histologic subtype with highly aggressive clinical behavior. 1148 71

We investigated whether recombinant human TSH (rhTSH) safely and effectively induces uptake of high-dose 131-iodine (131I) to ablate thyroid remnant or treat disease, in patients with well-differentiated thyroid carcinoma. Eleven consecutive patients unable to tolerate thyroid hormone withdrawal received one im injection of 0.9 mg rhTSH on 2 consecutive days before receiving 4000 MBq (approximately 108 mCi) radioiodine orally. Eight patients received one, and 3 patients 2 courses. Our series comprised 7 women and 4 men (mean age, 78 yr, range: 56-87 yr). Ten patients had undergone total or near-total thyroidectomy up to 19 yr earlier. rhTSH-stimulated single course radioiodine with the intention to ablate thyroid remnant was performed in 3 patients, with following estimation of radioiodine uptake and TG measurements. Of another 8 patients given this treatment palliatively, 5 had radiological, clinical and/or laboratory response, including: 80% decreased pathological uptake between treatment courses; pronounced decrease in bone pain; diminished symptoms; improved physical condition and quality of life; lower serum TG concentration; and/or normalization of TG recovery test. Two patients with small lung metastases on computed tomography had no detectable radioiodine uptake or other response; they also lacked uptake after withdrawal-stimulated radioiodine treatment. Despite being elderly and frail, patients generally tolerated treatment well; rhTSH caused nausea in one patient and transiently increased pain in bone and soft tissue lesions in another. We conclude that rhTSH-stimulated high-dose radioiodine for remnant ablation or tumor treatment is safe, feasible and seemingly effective, enhancing quality of life and offering reasonable palliation in patients with advanced disease.
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PMID:Radioiodine ablation and therapy in differentiated thyroid cancer under stimulation with recombinant human thyroid-stimulating hormone. 1188 65

At present, no effective therapy is available for hepatocellular carcinoma, when local treatments have failed. We reported the results obtained with prolonged, ultra-low-dose (1 MIU/d until progression), subcutaneous interleukin-2 (IL-2) in a series of 18 consecutive patients (14 men and 4 women, median age 66 years, range 49-82 years) with advanced, histologically proven HCC on liver cirrhosis. During a median follow-up time of 19.5 months, two complete responses (11.1%), lasting 35 and 46 months, respectively, and one partial response (5.5%) were recorded (overall response rate: 16.6%; 95% CI: 0-33.8%). Thirteen patients (72.3%; 95% CI: 61.6-82.7) had stable disease lasting at least 4 months; 1 of these patients obtained a complete response on lung metastases. Median time to progression was 15.3 months (95% CI: 10-33). Median overall survival was 24.5 months (95% CI: 12-43). Two patients (11.1%) progressed during therapy. Toxicity was only local (usually pain and pomphus in the site of injection). Low-dose IL-2 can be considered an active and well-tolerated treatment for unresectable hepatocellular carcinoma. Future studies on large numbers of patients are necessary to confirm these results.
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PMID:Ultra-low-dose interleukin-2 in unresectable hepatocellular carcinoma. 1204 Feb 76

The authors analyse the long-term and in-hospital results of treatment 29 patients with renal neoplasms, who underwent transcatheter renal arterial embolization and also discuss the benefits of transcatheter renal arterial embolization in other clinical situations. Transcatheter renal arterial embolization was performed with embosil for 23 patients (79.3%) and with concentrated alcohol for 6 patients (20.7%) before nephrectomy of advance renal tumour in 21 patients. Transcatheter renal arterial embolization was performed as palliative treatment in 8 patients. Complete embolization was achieved in 27 patients (93.1%), incomplete--in 2 patients (6.9%). Nephrectomy was performed after 22.14 +/- 9.28 days. The most evident post procedural reactions were moderately elevated temperature in 22 patients (75.9%), highly elevated temperature (> 38 degrees) in 7 patients (24.1%) and pain. Only 6 patients (20.7%) didn't feel pain. One hematoma was noticed in puncture region. After 5 years, 4 patients of 10 analysed patients are still alive (all-pT3, size of tumor 6.5-9 cm.). Two patients were not operated due to very big tumor and technical inoperability. Remaining 4 patients died during 2-3 years. As exclusion was one patient with inoperable renal tumor and lung metastases. After transcatheter renal arterial embolization he was alive 4 years. In conclusion, transcatheter renal arterial embolization was effective in diminishing the technical difficulties to remove advance tumors and in treatment of inoperable patients. It's rational to supply transcatheter renal arterial embolization with embolization and chemoembolization of primary and metastatic lesions.
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PMID:[Transcatheter renal arterial embolization in malignant renal neoplasms: clinical results and indications for use of the method in multi-profile hospitals]. 1247 71

We report 4 cases of malignant peripheral nerve sheath tumors (MPNST) with neurofibromatosis type 1 (NF1). Mean age was 29.5. Two of them had a family history. Three of them were male. All of them had enlarging mass and pain in the background of neurofibromas. Locations were popliteal, thigh and forearm. The masses were greater than 5 cm in diameter in each case. In two cases the mass was showing continuity with a nerve. One patient had a nonossifying fibroma as well as a MPNST. Wide excision and radiotherapy were applied to three of the patients. One of them did not take any therapy after surgical resection. Two of the patients died of lung metastases after a mean period of 12.5 months. In a majority of NF1 patients MPNST emerges from a preexisting neurofibroma. The patients with NF1 are at greatest risk for developing sarcomas, so they should be followed closely.
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PMID:Malignant peripheral nerve sheath tumors associated with neurofibromatosis type 1. 1453 Aug 18

A 54-year-old woman underwent abdomino-perineal resection for rectal cancer. Six months after surgery, perineal pain and the tumor marker increased. Local recurrence of the pelvic cavity and lung metastases were diagnosed by computed tomography (CT) and positoron emission tomography (PET) using 18F-fluorodeoxygulucose (FDG). Local perineal pain continued and there was no increase in the neoplastic lesion of the lung, so surgical treatment was performed. After partial resection of the lung, local resection of the gluteus maximus and posterior wall of the vagina was performed with the patient in the Jack-knife position. To fill the defect, a femoral posterior flap was made and the perineal defect was reconstructed.
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PMID:[A case of local recurrence of rectal cancer in which trans-sacral resection and perineal reconstruction by femoral posterior flap were performed]. 1461

Not unlike thermoablation of liver metastases, thermoablation of metastases to the lungs is gaining clinical interest. Radiofrequency ablation and laser-induced interstitial thermotherapy are both used clinically. Initially it was suspected that percutaneous treatment of lung metastases would result in a rate of pneumothoraces and tissue reactions which would not be clinically acceptable. However, this did not prove true. Fear of pneumothoraces however did lead to the desire for an applicator with a maximally reduced diameter. While clinical results are not yet available, technical success rates of laser-induced interstitial thermotherapy of lung metastases are promising. The percentage of pneumothoraces does not differ significantly from that seen in diagnostic procedures. Large metastases may be treated by simultaneous use of multiple applicators or by repositioning of an applicator (pullback technique). Surgical experience is still guiding us in deciding which primaries' metastases may be successfully treated percutaneously. The literature indicates that lung metastases from colorectal primaries are especially suited. Radiotherapy is only an alternative method in cases of lung metastases if they cause symptoms (such as pain because of thorax infiltration or difficulty in breathing because of bronchial lesion). Due to the risk of radiation-induced pneumonia general radiotherapy is not to be recommended. The possibility of stereotactic ray treatment is being considered, but because breathing shifts the metastases it is not yet feasible. Therefore, percutaneous thermoablation could be used as a minimally invasive, rather riskless therapeutic option for a relatively high percentage of inoperable lung metastases.
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PMID:[Percutaneous thermoablation of lung metastases. Indication, performance, initial results, and imaging findings]. 1508 68

We prospectively identified prognostic factors and developed a prognostic scale in 356 Taiwanese terminal cancer patients (training set). Demographic data, severity of symptoms/signs, and survival were statistically analyzed to create the scale, which was tested in another 184 patients (testing set). In the training set, liver and lung metastases, functional performance status, weight loss, edema, cognitive impairment, tiredness, and ascites were independently associated with shorter survival (multivariate analysis). The scale ranged from 0.0 (no altered variables) to 8.5 (maximal alteration for all variables). When scores were < 3.5, 2-week survival was predicted with 0.72 and 0.61 accuracy for the training and testing sets, respectively. With scores < 6.0, 1-week survival was predicted with 0.72 and 0.66 accuracy, respectively. This scale, which includes lung and liver metastases and severity of symptoms/signs, may help in identifying the stage of dying and its corresponding symptoms/signs and also in improving survival prediction in terminal cancer patients.
J Pain Symptom Manage 2004 Aug
PMID:Prediction of survival in terminal cancer patients in Taiwan: constructing a prognostic scale. 1527 92


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