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)

Malignant bowel obstruction (MBO) is a common and distressing outcome particularly in patients with bowel or gynaecological cancer. Radiological imaging, particularly with CT, is critical in determining the cause of obstruction and possible therapeutic interventions. Although surgery should be the primary treatment for selected patients with MBO, it should not be undertaken routinely in patients known to have poor prognostic criteria for surgical intervention such as intra-abdominal carcinomatosis, poor performance status and massive ascites. A number of treatment options are now available for patients unfit for surgery. Nasogastric drainage should generally only be a temporary measure. Self-expanding metallic stents are an option in malignant obstruction of the gastric outlet, proximal small bowel and colon. Medical measures such as analgesics according to the W.H.O. guidelines provide adequate pain relief. Vomiting may be controlled using anti-secretory drugs or/and anti-emetics. Somatostatin analogues (e.g. octreotide) reduce gastrointestinal secretions very rapidly and have a particularly important role in patients with high obstruction if hyoscine butylbromide fails. A collaborative approach by surgeons and the oncologist and/or palliative care physician as well as an honest discourse between physicians and patients can offer an individualised and appropriate symptom management plan.
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PMID:Management of malignant bowel obstruction. 1835 21

A 41-year-old female suffered from epigastralgia and intermittent constipation for 10 months, and abdominal fullness and intermittent pain for 6 months, before seeking help. Double contrast barium study of the colon showed multiple indentations on the sigmoid, ascending, and proximal transverse portions with tethered adjacent mucosal outline as well as the presence of ascites compatible with peritoneal carcinomatosis. Mediolateral oblique mammogram showed a speculated mass with some intratumoral microcalcifications in the upper retroareolar portion of the right breast. Due to the persistent abdominal complaints, laparotomy was done. Breast lump biopsy was done simultaneously. On opening abdominal cavity, massive yellowish ascites was noted. Diffuse small nodules over omentum and mesentery retraction were found. Bilateral ovarian masses were also noted. Right oophorectomy and omentectomy were performed. Histologic findings and results of immunohistochemical stains were consistent with diagnosis of primary breast cancer with metastasis to ovary and omentum.
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PMID:Abdominal carcinomatosis attributed to metastatic breast carcinoma. 1880 83

A 64-year-old man complaining of left hypochondriac pain visited our hospital. He was diagnosed as locally advanced unresectable cancer of the pancreatic body over 4 cm in size, because the pancreatic cancer involved the main artery and portal vein. Although chemotherapy of gemcitabine(GEM)(1.2 g/body/week)was started, he developed meningeal carcinomatosis after 2 courses of GEM. The size of the primary lesion decreased at this period, and total brain irradiation was selected to treat the meningeal carcinomatosis. He sequentially received GEM alone afterward until radiotherapy was performed for the progression of the primary lesion 24 months after the diagnosis. Although GEM alone was continued thereafter, vertebral metastases were detected 30 months following the diagnosis. He was treated with combined chemotherapy of GEM and S-1 that was effective. Finally, he died of peritoneal dissemination 42 months after diagnosis. The dose of GEM was reduced during the radiotherapy, and the total dose was 113.2 g.
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PMID:[A long survival case of unresectable pancreatic cancer by chemoradiotherapy with gemcitabine as key drug]. 1909 14

This article describes the signs for suspecting neoplasia that lead the patient to come to the Accident and Emergency Service, concentrating on genital bleeding, pelvic mass and vulvar pruritus. Patients can also come due to processes resulting from complications of the disease, such as urethral obstruction, carcinomatosis, ascites, thromboembolic processes, haemorrhages, constipation, nausea and vomiting, intestinal obstruction and pain. Finally, we describe complications that are secondary to the treatment, such as abdominal and inguinal lymphocele and post-radiotherapy enteritis and proctitis.
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PMID:[Emergencies in oncological gynaecology]. 1943 35

A 61-year-old man was admitted to our department with radicular back-pain and progressive gait-difficulties. On examination he had flaccid paraparesis and bladder-retention. He subsequently developed palsy of n. oculomotorius, dysarthria, right-sided Bells palsy and weakness of his right arm over a 4-week period. He became disoriented and died without a diagnosis. MRI of the brain and columna were negative. Extensive search for malignancies yielded negative results. Cytology specimens were inconclusive and repeated liquor-examinations showed very low glucose levels, mild pleocytosis, elevated protein. Autopsy revealed a small adenocarcinoma of the lung and meningeal carcinomatosis originating from the adenocarcinoma.
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PMID:[A 61-year-old man with sciatica]. 1944 55

A 33-year-old man was admitted to our hospital due to DIC and multiple bone metastasis after distal gastrectomy for gastric cancer (Stage IIIB). We diagnosed disseminated carcinomatosis of bone marrow by gastric cancer. The patient was treated with combination chemotherapy of S-1 and CDDP (S-1 80 mg/m (2), po, day 1-21 and CDDP 60 mg/m(2), iv, day 8). After one course of the treatment, DIC was resolved and severe pain in his back and legs which had been poorly controlled was dramatically improved. He could thus be discharged from our hospital and survived for about six months. S-1 and CDDP therapy are considered to be effective for disseminated carcinomatosis of bone marrow due to gastric cancer, even if complicated by DIC.
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PMID:[A case of advanced gastric cancer with disseminated carcinomatosis of bone marrow treated by S-1 and CDDP]. 2000 74

Peritoneal carcinomatosis remains an unsolved medical problem in modern oncologic treatment. Excruciating symptoms such as malignant ascites, ileus, nausea, vomiting, dyspnoea and pain deteriorate the quality of life for affected patients. There is still no effective standard treatment for peritoneal carcinomatosis. The trifunctional antibody catumaxomab (antiepithelial cell adhesion molecule x anti-CD3) is able to direct T lymphocytes and Fcg-receptor-positive accessory cells to epithelial cell adhesion molecule-positive tumor cells. Intraperitoneal catumaxomab therapy was shown to be the first effective therapy against accumulation of malignant ascites in patients with peritoneal carcinomatosis of epithelial cancer, reducing the need of paracentesis and prolonging puncture-free survival. This paper reviews the mode of action of catumaxomab and analyzes different fields of local immunotherapy in patients with peritoneal carcinomatosis. A summary of completed and ongoing studies is included. Catumaxomab is discussed to be an outstanding option for local control and therapy of peritoneal carcinomatosis, which could be an optimal modular therapy in addition to systemic chemotherapy and surgical tumor resection.
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PMID:The trifunctional antibody catumaxomab in treatment of malignant ascites and peritoneal carcinomatosis. 2091 24

The differential diagnosis for what may seem an inguinal hernia may be complex, as lateral pain may be of many types of origin. We report the case of a 48-year-old female patient who presented with a history of painful, progressively protruding soft bulging masses over the bilateral inguinal area and a 20-year history of head cancer and hepatitis B virus. Pathological analysis, gynecological ultrasound and abdominal computed tomography scan were required to make final determination. Final diagnosis was Stage IV ovarian carcinomatosis, which responded to chemotherapy. Initial diagnosis of inguinal hernia should not rule out other potential diagnoses, particularly in complex cases with other risk factors.
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PMID:Ovarian carcinomatosis presenting as bilateral inguinal hernia: a brief report. 2107 86

Leptomeningeal Carcinomatosis (LC) refers to diffuse seeding of the leptomeninges by tumor metastases and is a rare presentation of solid tumors, particularly breast cancer, lung cancer and malignant melanoma in adults and hematogenous malignancies and primitive neuroectodermal tumor (PNET) in children. Recently, the incidence of LC has been reported to be increasing due to a longer overall survival obtained in patients treated with novel antineoplastic agents. The usual clinical presentation is a multifocal involvement of the neuraxis, with headache and radicular pain being the most common initial symptoms. The most frequent signs are motor deficits, altered mental status and cranial nerve involvement. The treatment of LC remains controversial and no straightforward guidelines exist in the literature. It has a bad prognosis and inevitably fatal outcome despite aggressive therapy.
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PMID:Newer avenues for the treatment of leptomeningeal carcinomatosis. 2125 Sep 35

Cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is now an established therapy with a curative option for patients with gastrointestinal and gynecological peritoneal carcinomatosis as well as for primary peritoneal carcinomatous tumors. Decisive for the prognosis is a complete cytoreduction, which in most cases necessitates multi-organ resection in addition to a partial or subtotal parietal peritonectomy (PE). The highest priority is given to maintain an adequate quality of life for the patient while performing maximum tumor resection. The morbidity following PE and HIPEC in experienced centers lies between 25% and 35% with a mortality risk of <5%. Consideration must be given not only to the technical surgical aspects and the intraoperative decision-making but also to the intraoperative management, intensive care therapy, pain therapy, management of complications, physiotherapy and many more. The greatest challenge in the management of peritoneal carcinomatosis is still patient selection. Computed tomography imaging together with (18)fluorodeoxyglucose positron emission tomography (FDG-PET) plays an important role in the assessment of operability.
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PMID:[Peritoneal carcinomatosis]. 2142 89


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