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)

When an accessory soleus muscle is present, it consists of a soft-tissue mass bulging medially between the distal part of the tibia and the Achilles tendon. It usually inserts with a separate tendon on the calcaneus anteromedial to the Achilles insertion, and may be a cause of pain on exercise. One may suspect a soft-tissue tumor, such as lipoma, hemangioma, and even sarcoma, but the anomalous muscle has a typical appearance on plain radiographs, and the appearance on computed tomography is diagnostic. If the patient is asymptomatic, no therapy is required, but if pain or other discomfort is provoked by exercise, exploration with fasciotomy or excision of the accessory muscle is recommended, as was done in six of our eleven patients who were seen between 1968 and 1985.
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PMID:Accessory soleus muscle. A clinical and radiographic presentation of eleven cases. 372 30

This study represents the examination of 14 primary, malignant pleural tumours--10 mesotheliomas and 4 sarcomas--in respect of the radiological appearance and clinical signs and symptoms. The presentation was widely different in the mesothelioma patients: 3 presented the radiological image of a mantle-like apicocaudal callosity. In 3 patients and extrapulmonary space-occupying growth was seen; one case presented with an interlobar effusion. Pleural effusion was additionally present in 6 cases. Of the 4 sarcoma patients, 3 presented with an intrapulmonary space-occupying growth and one only with an extrapulmonary lesion. Pleural effusion was definitely seen in 2 patients with pleural sarcoma. Therapy-resistant refractory thoracic pain was the principal clinical sign. Other symptoms were not so frequent, such as loss of body weight, tiredness, dyspnoea, hemoptysis and cough.
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PMID:[Primary malignant tumors of the pleura]. 372 17

Postradiation sarcomas arising many years after treatment of cancer are long term sequelae of therapy. We describe the clinical features, radiographic findings, and results of treatment in 13 patients with such sarcomas encountered over a 6-year period. Of these patients, 9 had bone sarcomas and the remaining 4 had paraspinal tumors arising from adjacent soft tissue and nerve. The primary cancer for which radiation was given included Hodgkin's disease (4 patients), breast cancer (2 patients), cervix cancer (2 patients), and a variety of others (5 patients). The latent interval to the occurrence of the second neoplasm varied from 6 to 30 years (median, 10 years) after treatment of the original tumor. Despite aggressive treatment, the overall prognosis was poor. The median survival was 8 months, with only 3 surviving more than 2 years. Although rare, postradiation sarcoma should be considered in the differential diagnosis of patients presenting with late onset of spinal pain or neurological symptoms after clinical remission of an original cancer.
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PMID:Postradiation sarcoma involving the spine. 373 99

The four main histologic categories of malignant small intestine tumors are (1) adenocarcinoma, (2) sarcoma, (3) carcinoid, and (4) lymphoma. Signs and symptoms may be chronic or acute and include bleeding, obstruction, pain, and weight loss. When chronic, the symptoms are so vague that early diagnosis is difficult. Often the diagnosis is made only at the time of surgery. Treatment is segmental resection of intestine with adequate margin of the tumor and resection of the regional lymph nodes. Prognosis is evaluated by tumor extension through the bowel wall and lymph node metastasis. The 5-year survival rates are low except for carcinoid and lymphomatous lesions.
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PMID:Malignant tumors of the small intestine. 373 98

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

A case of epithelioid sarcoma of the penis in a thirty-two-year-old man is presented. It had been present for two and one-half years as a small nodule on the ventral aspect at the base of the penis that eventually grew to large dimensions causing pain and extreme dysuria. A local resection was done; however, when tumor recurred, penectomy was undertaken followed by an incomplete course of radiotherapy. Fifteen months after surgery the patient was free of local recurrence but was in poor condition with metastases to regional and distant lymph nodes, lungs, and scalp--a pattern of spread characteristic of these tumors. This is a typical example of epithelioid sarcoma clinically, histologically, and ultrastructurally, despite the rare location.
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PMID:Epithelioid sarcoma of penis. 375 Jun 10

Soft tissue sarcomas are uncommon malignancies, less than 10% of which arise on the distal upper extremities. Consequently, experience with treatments which preserve both the limb and its function is lacking for tumors in this region. Sixteen patients with sarcomas arising in the hand and wrist and one with an aggressive desmoid tumor were treated by combined modality therapy at the Massachusetts General Hospital. Two patients had wide resections for multiple recurrent lesions, 5 had excisional biopsies, and 9 had incomplete excisions to preserve anatomic structures of the hand. One patient refused an amputation and had no surgery. Sarcoma patients were given postoperative radiation with a dose range of 50.2 to 69 Gy (median 68 Gy). The desmoid tumor received 44 Gy. A shrinking field technique with customized castings and cerrobend blocks was used to assure precision and minimize treatment volumes. Chemotherapy was reserved for metastatic disease. Local control was achieved in 14 patients who received combined modality treatment (87%), with a follow-up 1-12 years (median 33 months). Two of the three patients with local failures subsequently obtained a local control after salvage surgery and radiation. Four patients developed metastases, one with epitrochlear lymph node metastases was salvaged by amputation, the others died with lung disease 17, 37, and 111 months after treatment. Functional integrity of the limb was primarily dependent on the extent of surgical resection required. Among 12 patients with local and distant control, one patient (who had multiple wide resections of an extensive desmoid tumor preceding irradiation) lost over 50% use of her limb, but no patients required amputation for edema or pain control. Ten of the 12 patients with local and distant control had less than a 25% decrement in limb function and had no pain or edema associated with normal use of their hand. We conclude that for selected patients with sarcomas of the distal upper extremity, combined modality therapy consisting of conservative resection and careful radiation therapy is a viable alternative to amputation.
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PMID:Extremity preservation by combined modality treatment of sarcomas of the hand and wrist. 377 12

Computed tomographic (CT) and angiographic findings in 14 patients (eight men, six women, aged 30-72 years) with sarcomatoid renal cell carcinoma (SRCC) and various types of renal sarcoma are described. There were four patients with SRCC; three, leiomyosarcoma; two, liposarcoma; two, fibrosarcoma; and one each of unclassified renal sarcoma, clear cell sarcoma, and malignant fibrous histiocytoma. The most frequent presenting symptom was an abdominal mass or pain. All 14 patients underwent CT, and 11 underwent selective renal angiography. The diagnosis of renal sarcoma should be suspected when CT findings suggest that the tumor arises from the renal capsule or renal sinus and when the tumor is hypovascular or avascular on angiograms. The characteristic negative attenuation values for liposarcomas permit a specific diagnosis. Sarcomas that originate in the renal parenchyma and SRCC cannot be easily differentiated from renal cell carcinoma; however, renal sarcomas do not appear to have a propensity for extension into the renal vein or the inferior vena cava.
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PMID:Renal sarcoma and sarcomatoid renal cell carcinoma: CT and angiographic features. 379 47

A 9-year-old Latin American girl developed proptosis of the left eye associated with pain in the left ear of one month's duration. Ophthalmoscopic examination of the left eye disclosed retinal striae with venous tortuosity and papilledema. CT scan of the orbit showed a nonenhancing, irregular intraconal mass. CT scan of the brain demonstrated an enhancing left temporoparietal mass. Craniotomy revealed a 7 cm, extra-axial mass that was attached to the dura mater. Histologic examination, including a positive Leder stain, established the diagnosis of granulocytic sarcoma. At that time, the results of the laboratory studies, including complete cell blood count, were normal. Periodic clinical and hematologic evaluation was recommended. Twenty-five days after craniotomy, examination of the peripheral blood disclosed 56% myeloblasts and the bone marrow contained 30% blast cells. The problem in histologic differential diagnosis and a review of the literature is discussed.
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PMID:Granulocytic sarcoma of the orbit. A clinicopathologic study. 386 55

The skeletal effects of radiation are dependent upon many variables, but the pathologic features are consistent. Radiation may cause immediate or delayed cell death, cellular injury with recovery, arrest of cellular division, or abnormal repair with neoplasia. Radiation necrosis and radiation-induced neoplasm still occur despite the use of supervoltage therapy. Complications of radiotherapy are well known and have led to more judicious use of this therapeutic modality. With few exceptions, benign bone tumors are no longer treated with irradiation. Radiation necrosis may be difficult to differentiate from sarcoma arising in irradiated bone. They both occur within the field of irradiation. Radiation necrosis often has a long latent period which is, of course, the rule in radiation-induced neoplasia. A soft tissue mass favors the diagnosis of neoplasia, while its absence suggests radiation necrosis. Lack of pain favors necrosis. Calcification may occur in radiation necrosis and does not indicate neoplasia. A lack of progression on serial roentgenograms also favors radiation necrosis.
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PMID:Complications of radiation therapy. 389 Dec 33


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