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

A 35-year-old Japanese man was admitted to the National Cancer Center, Tokyo, Japan, in December 2000, with a 2-month history of pain around the left thigh. Radiographs showed a poorly demarcated osteolytic lesion with focal mineralisation and endosteal scalloping in the left proximal femur. Biopsy showed a proliferation of highly anaplastic cells without any cartilaginous component. A wide excision of the left proximal femur with a replacement by endoprosthesis was carried out in February 2001 after treatment with methotrexate and 20 Gy radiation therapy. Pathological examination of the surgical specimen showed a focus of low-grade chondrosarcoma and the coexistence of telangiectatic osteosarcoma-like features. The patient was diagnosed with dedifferentiated chondrosarcoma with telangiectatic osteosarcoma-like features. Lung metastasis appeared in July 2001 despite an adjuvant chemotherapy including methotrexate, cis-platinum and doxorubicin. The latest follow-up study in June 2004 showed multiple lung metastases. Establishing a definitive diagnosis of dedifferentiated chondrosarcoma may be difficult with limited small biopsy specimens. Dedifferentiated chondrosarcoma should be included in the differential diagnosis of osteolytic tumours with focal calcification and endosteal scalloping even if an extraosseous tumour component is not identified.
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PMID:Dedifferentiated chondrosarcoma with telangiectatic osteosarcoma-like features. 1707 6

We present a case of an atypical recurrent meningioma of the sacrum with pulmonary metastasis in a 31-year-old man. He presented with deep-seated buttock pain and urinary hesitancy for 3 months. MRI revealed a lesion occupying the central and left side of the sacral canal at the S1-S2 level. Surgical excision of the lesion via a posterior approach was undertaken, and the patient became symptom-free post-operatively. Histology confirmed atypical meningioma. Eight months later he re-presented with similar symptoms, and MRI confirmed local recurrence. The patient underwent left hemisacrectomy. Six months later he again presented with low back pain and MRI confirmed a second local recurrence. A CT scan of the chest showed multiple lung metastases. The patient died of a severe chest infection 18 months later.
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PMID:Primary atypical sacral meningioma--not always benign. 1709 57

A 55-year-old male presented with a 1-month history of localized pain caused by an osteolytic and destructive lesion in the right distal femur. Histologically, the tumour consisted of spindle cells intermingled with epithelioid eosinophilic cells arranged in small cords embedded in a hyalinized-to-chondromyxoid stroma. Electron microscopy and immunohistochemistry showed features of myoepithelial differentiation. RT-PCR failed to demonstrate chimeric transcripts of extraskeletal myxoid chondrosarcoma. The final diagnosis was primary malignant myoepithelioma of bone. The patient is alive with lung metastases 13 months after surgery. Primary malignant myoepithelioma of bone is an exceptionally rare neoplasm that should be considered in the differential diagnosis with the more aggressive myxoid spindle cell sarcomas.
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PMID:Primary malignant myoepithelioma of the distal femur. 1750 7

Interventional radiology has made great progress during the past decade. In thoracic oncology image guided, percutaneous procedures may be divided into two groups: diagnostic and therapeutic. The routinely performed diagnostic procedures include percutaneous biopsy of parenchymal and mediastinal lesions under fluoroscopic or CT guidance. The therapeutic procedures are mainly concerned with the relief of pain. Percutaneous injection of alcohol into bone metastases was one of the first techniques used. Percutaneous vertebroplasty by injection of acrylic cement into lytic lesions of the vertebral bodies is one of the most successful techniques in interventional radiology. Acrylic cement can also be injected into other flat bones such as the acetabulum. Finally, percutaneous tumour ablation by radiofrequency or cryotherapy represents a major advance in interventional oncology. In fact thermo-ablation of tumours has advantages over alcohol injection with better delimitation of the ablation without risk of leakage. It can be performed on different organs for palliation or cure. For pain relief, bone and other metastases can be treated with radiofrequency or cryo-ablation with excellent results. Lung tumours less than 5 cm in diameter can be treated with radiofrequency ablation if surgery is contra-indicated. Similarly, up to 5 lung metastases can be treated by either radiofrequency or cryo-ablation.
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PMID:[Interventional radiology in lung cancer: from diagnosis to treatment]. 1823 7

Prostatic stromal sarcoma (PSS) is an unusual lesion that is reported only occasionally. Here we describe a case of prostatic stromal sarcoma in a 33-year-old man who had complained of perineal pain. The serum prostate-specific antigen (PSA) level was above the normal limit at 5.8 ng/ml, and abdominal computed tomography (CT) revealed a giant mass in the retrovesical region. Chest CT demonstrated lung metastases. Specimens obtained by transrectal needle biopsy of the prostate suggested a mesenchymal tumor, but a precise diagnosis required a larger specimen. Palliative transurethral resection (TUR-P) was performed because of obstruction of the urogenital tract, and the final diagnosis was made from this specimen. The tumor contained yellowish gelatinous materials, and the stromal element appeared histologically malignant, with increased cellularity, mitotic figures and pleomorphism. The histological diagnosis was PSS, and the patient received VIP (etoposide, ifosfamide, cisplatin) chemotherapy regimen. However, the pelvic mass continued to increase in size, and the patient's condition rapidly deteriorated and he died. Sarcoma of the prostate gland showing aggressive behavior is quite rare. The detailed histological and immunohistochemical findings in this case are reported, together with a review of the literature.
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PMID:[Prostatic stromal sarcoma: a case report]. 1826 Mar 57

A 61-year-old man underwent amputation of the rectum for advanced lower rectal cancer in April 2005. UFT-E granules were administered orally daily at 400 mg/body/day following surgery. He developed perineal pain and perineal discharges following an increase the CEA level in April 2006. PET revealed a tumor in the perineum and multiple lung metastases. Chemotherapy with mFOLFOX 6 for 8 courses and FOLFIRI 2 for 4 courses were administered since July in 2006. Although CT revealed a the reduction in multiple lung metastases, CEA was increased to over a maximum 109, high fever continued and the pinealtumor was enlarged in December 2006. The patient underwent resection of the perinealmass, but he developed perinealsevere pain and perinealdischarge. So radiotherapy of the pelvic region was given at a total dose of 40 Gy(given 2 Gy each fragment)followed by administration of FOLFIRI 2 for 12 courses. After chemoradiotherapy, the CEA level was remarkably decreased. PET could not detect any mass in lung fields and revealed a little accumulation in the pelvic region. Chemotherapy with FOLFIRI 2 is administered monthly now, and the CEA level has been within the normal range since July of 2007. The pineal pain and pineal discharge disappeared, so the quality of life has improved dramatically.
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PMID:[Combination chemotherapy composed of mFOLFOX 6, FOLFIRI 2 and surgery and radiation therapy for locoregional recurrences and multiple lung metastases from rectal cancer--a case report]. 1863 65

The purpose of this study was to prospectively evaluate the use of ultrasonographically guided high-intensity focused ultrasound (HIFU) in the salvage of limbs in patients with osteosarcoma. Seven patients underwent HIFU ablation. Laboratory and radiologic examinations were performed after intervention. Changes in symptoms and survival time were noted at follow-up. No severe complications were observed, and preexisting severe pain disappeared in patients treated with HIFU. Alkaline phosphatase did not show statistically significant changes before and after HIFU treatment, although Alkaline phosphatase did change 1 mo and 2 mo after HIFU. Complete response of the tumor was achieved in three patients with osteosarcoma. Partial response was achieved in another three patients treated with HIFU. Pulmonary metastasis was noted in only one patient 5 mo after HIFU. The median survival time was 68 mo. All patients were alive 3 y after HIFU treatment. Five patients were alive at follow-up visits after 5 y. One patient died from cachexia and infection after 4 y, another patient died of cardiac arrest attack after 4 y. Three patients died of lung dysfunction from pulmonary metastases after 5 y. The five-year survival rate was 71.4%. The authors concluded that HIFU ablation was a safe and feasible method of treatment of osteosarcoma which salvages the limb, but large-scale randomized clinical trials are necessary for confirmation.
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PMID:Osteosarcoma: limb salvaging treatment by ultrasonographically guided high-intensity focused ultrasound. 1944 2

Survival analysis of 70 patients with metastatic extradural tumours of the spine is presented. The indication for surgery was rapidly progressive cord compression as a initial manifestation of a malignant disease in 28 cases (40%), a preoperatively known malignant tumour in 28 patients (40%), relapse of cord compression after previous successful radiotherapy in 10 cases (14%), instability in 3 patients (4%) and uncontrolled pain in 1 patient. In 53 procedures (76%) the level of compression was in the thoracic spine, in 9 procedures in the cervical spine (13%) and in 8 procedures in the lumbar spine (11%). All patients had developed a neural deficit before surgery. Fourteen patients (20%) were able to walk prior to surgery, 47 (67%) were paraparetic, and 9 (13%) were paraplegic. Eleven patients died in the first 2 weeks following surgery and out of 59 patients who survived, 39 patients (66%) were able to walk, 11 were paraparetic (19%), and 9 were still paraplegic (15%). Bowel and bladder dysfunction was present in 37 cases (53%) before surgery and in 16 cases (27%) after surgery. Normal sphincter control was regained after 43 (73%) procedures. Persistent back pain was present in 60 patients (86%) before surgery and in 13 patients (22%) after surgery. The mean survival time for all 70 patients was 45.6 weeks. There were 11 early deaths (16%), another 51 patients died from disseminated disease (88%), and 8 patients are still alive (11%) with a mean survival of 133 weeks. A statistically significantly shorter survival was found in patients with lung metastases when compared with the survival of patients with breast metastases and the overall survival of patients with other metastatic tumours.
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PMID:Metastatic spinal tumours: survival after surgery. 2005 47

A 65-year-old man underwent a total gastrectomy and distal pancreatectomy for acinar cell carcinoma of the pancreas. Multiple metastatic liver lesions were found one year postoperatively. He was treated with S-1 chemotherapy over 34 months, and the tumors significantly reduced in size without severe side effects. Four years after surgery, the liver metastases increased in size, associated with pain especially in the right upper quadrant. We then performed right hepatectomy. Peritoneal dissemination and multiple lung metastases were found 8 months after liver resection. Acinar cell carcinoma of the pancreas is a rare and highly malignant tumor, and there are few reports regarding treatment with chemotherapy. Herein, we report a case with multiple liver metastases which were controlled by systemic chemotherapy using S-1.
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PMID:[A case of acinar cell carcinoma of pancreas with liver metastases treated effectively by S-1]. 2008 46

Adenocarcinoma of the rete testis is a rare malignant tumor with a poor prognosis. About 60 cases of this adenocarcinoma have been reported in the literature. The diagnosis is often difficult and made incidentally. Herein, we report a case of adenocarcinoma of the rete testis and review the literature. Our patient was an 80-year-old man who presented with painless scrotal swelling for 2 years. Physical examination revealed an enlarged, hard mass of the left scrotum. The serum markers alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (beta-HCG), and carcinoembryonic antigen (CEA) were negative. Magnetic resonance imaging (MRI) showed a left hydrocele with central necrosis of the testis. After 4 months, the patient presented with appetite loss, general fatigue, and pain in the left scrotum. Positron emission tomography (PET) was performed in another hospital, and the patient was referred for a left testicular tumor, multiple lung metastases, and para-aorta lymph node metastasis. The patient underwent left high inguinal orchiectomy. Pathological examination revealed a hard whitish mass around the testis involving the epididymis and tunica vaginalis and spreading under the subcutaneous tissue. Histological examination revealed adenocarcinoma in the hilum of the testis, which extended to the subcutaneous tissue but not to the surface of the scrotum. The tunica albuginea was intact, and no invasion of carcinoma in the testis was seen. After the histological diagnosis of adenocarcinoma of the rete testis was confirmed, computed tomography (CT) was performed and showed multiple pulmonary nodules and para-aortica lymph node swelling of 3 cm diameter. Because the patient did not wish to receive chemotherapy or other aggressive treatment, he has been followed-up with palliative care since his diagnosis. Although local recurrence has occurred 4 months later, he is still alive for 8 months since his diagnosis.
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PMID:[Adenocarcinoma of the rete testis. A case report]. 2117 41


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