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)

A 68-year-old man with old-standing Paget's disease of bone developed in 1975 an isolated sarcoma of the left elbow confirmed by biopsy. The sarcoma responded to irradiation and multiple chemotherapy. In August 1979, pain started along the right sciatic nerve. Clinical examination revealed a tumour deep in the right gluteal region, which was found to be another sarcoma close to the sacro-iliac joint, Cobalt irradiation produced little symptomatic improvement, and the patient died four months later, presumably of metastases. Since January 1979 the Paget's disease had been treated with dichloromethylene diphosphate with satisfactory clinical, biochemical and histological results, but the drug did not influence the course of the sarcoma.
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PMID:[Multifocal sarcoma associated with Paget's disease of bone. Effects of dichloromethylene diphosphate (author's transl)]. 645 48

Functional outcome was evaluated in 40 patients with a diagnosis of soft tissue sarcoma (STS), who had received wide local surgical excision and postoperative radiation therapy. All patients were two or more years postsurgical excision, and 1.75 or more years postradiation. Patients were separated into three anatomic groups: head, neck, or trunk (HNT); lower extremity (LE); and upper extremity (UE). Each patient was assessed for range of motion, muscle strength, edema, pain, activities of daily living (ADL), and vocational changes. There was significantly more (p = 0.037) edema in patients with LE lesions than in patients in either of the other groups. Patients with LE lesions had greater difficulty with ADL and mobility than those with UE or HNT lesions (p = 0.019), and vocational changes were more frequent (p = 0.055). Patients with lower extremity STS are at higher risk for developing disability than patients with STS at other anatomic sites.
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PMID:Soft tissue sarcoma: functional outcome after wide local excision and radiation therapy. 646 80

From all soft-tissue malignancies reported to the Swedish National Cancer Registry in Southern Sweden (1.3 mill. inhabitants) from 1964 through 1978, 278 cases were accepted as sarcomas after histologic re-examination. All these were malignancy-graded on a four-grade scale, without knowledge of the clinical course. A number of clinical and morphological variables were recorded and subjected to uni-, bi- and multi-variate analysis. Follow-up was available in all patients. The annual incidence rate over all ages was 1.4/100,000. The mean age was 58 years and males dominated (1.3/1). Malignant fibrous histiocytoma, liposarcoma and leiomyosarcoma were the most common histologic groups. Three-fourths of the tumors were high-grade malignant (Grade III-IV). Sixty per cent were deep-seated, having a median size of 8 cm compared to 4 cm for the superficial tumors. One third of all tumors were located in the thigh. The histologic groups were characterized by age, tumor depth and size, the occurrence of pain, malignancy grade and five-year survival; it was seen that each group, with respect to at least one of the variables, differed significantly from all the other groups. Thus histologic classification seems to identify different tumor entities. Out of several pair-wise associations the strongest were as follows: histologic groups versus depth, size, malignancy grade and age; depth versus size; and size versus malignancy grade (Grade IV tumors being larger). The proportion of superficial and small tumors in this series is high, compared to several reported series, probably owing to "referral selection" in the previous studies. The inter-relationships found between several variables and conclusions based on selected series may explain, in part, the differing opinions which can be found in the literature regarding prognostic variables in soft-tissue sarcoma.
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PMID:Epidemiology of soft-tissue sarcoma in the locomotor system. A retrospective population-based study of the inter-relationships between clinical and morphologic variables. 650 1

To identify variables of prognostic importance for soft-tissue sarcoma in the locomotor system, we performed a retrospective follow-up study on a consecutive, unselected, population-based series of 237 patients mainly treated by surgery, 1964-1978. Patients with metastasis at the time of diagnosis were not included. All histologic material was re-evaluated and histologic malignancy-grading (four-grade scale) performed without knowledge of the clinical course. The surgical procedures were classified as marginal and broad excisions. Patient follow-up ranged between 3- and 18 years. Multivariate analysis of the data by Coxs proportional hazard regression techniques disclosed seven negative prognostic variables of primary significance; high malignancy-grade (IV and III), pain at rest, male sex, increasing age and tumor size, a marginal excision and an extracompartmental tumor site, in order of decreasing relative risk (5.9-1.9) as regards survival. A secondary variable, that of local recurrence, was then included in the model and was found to have a stronger influence on survival than any of the other variables. Patients with local recurrence had a mortality risk which was 8.3 times that of patients without local recurrence. A risk curve based on the prognostic variables having primary significance was constructed. By this risk curve, patients with very good or very bad prognosis could be identified. The results are important when evaluating the efficiency of different therapies in non-randomized trials. In such studies the prognostic variables could be used to identify patients having comparable prognoses. In addition, patients found to have a good prognosis could be excluded from trials with adjuvant therapy.
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PMID:Prognosis for soft-tissue sarcoma in the locomotor system. A retrospective population-based follow-up study of 237 patients. 650 2

The effect of cesium therapy on various cancers is reported. A total of 50 patients were treated over a 3 year period with CsCl. The majority of the patients have been unresponsive to previous maximal modalities of cancer treatment and were considered terminal cases. The Cs-treatment consisted of CsCl in addition to some vitamins, minerals, chelating agents and salts of selenium, potassium and magnesium. In addition, a special diet was also instituted. There was an impressive 50% recovery of various cancers, i.e., cancer of unknown primary, breast, colon, prostate, pancrease, lung, liver, lymphoma, ewing sarcoma of the pelvis and adeno-cancer of the gallbladder, by the Cs-therapy employed. There was a 26% and 24% death within the initial 2 weeks and 12 months of treatment, respectively. A consistent finding in these patients was the disappearance of pain within the initial 3 days of Cs-treatment. The small number of autopsies made showed the absence of cancer cells in most cases and the clinical impression indicates a remarkably successful outcome of treatment.
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PMID:Cesium therapy in cancer patients. 652 27

The most serious complication of Paget disease is the development of sarcoma. Forty-one cases of bone sarcoma in Paget disease, which represented our institution's entire experience, were reviewed. The relative frequency of sarcomatous degeneration was 0.9%. Histologically, 35 of 41 lesions were osteogenic sarcomas, and six were fibrosarcomas. The distribution of lesions was similar to that expected with uncomplicated Paget disease, except for a disproportionately high number of lesions in the humerus; only one lesion involved the vertebrae. The tumors were categorized radiographically as lytic, mixed, and sclerotic, in descending order of frequency. The vast majority of lesions occurred in the pelvis, humerus, and femur. Overall prognosis for these patients was poor, with a five-year survival of 8%. Finding areas of cortical destruction is particularly useful in the detection of malignant degeneration. The radiologist must maintain a high index of suspicion when evaluating radiographs of patients with Paget disease, especially of those who present with pain or a palpable mass.
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PMID:Bone sarcomas in Paget disease. 657 60

Among 1177 osteogenic sarcoma patients diagnosed and treated at Memorial Hospital, 65 (5.5%) were associated with either monostotic or polyostotic Paget's disease. The overall median age was 64 years (range, 39-82 years). In those patients older than 40 years of age, the frequency of sarcomatous transformation rose to 27%. There were slightly more men (55%) than women. The most common skeletal sites were the pelvic bones (34%), the humerus (22%), the femur (19%), and the craniofacial bones (14%). Unrelenting pain and tender swelling were the most common presenting symptoms (85%), with pathologic fracture in 14 (22%) patients. In two-thirds of the cases, the radiographic presentation was that of a lytic destructive lesion; while in the others it showed a sclerotic, mixed, or permeative character. In almost one-half of the cases, the histologic appearance of the osteogenic sarcomas was either fibrohistocytomatous or osteoblastic. In spite of radical surgical amputations, only three patients survived longer than 5 years. The prognosis of Paget's sarcoma is significantly less favorable than in osteogenic sarcoma arising de novo in patients of comparable age.
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PMID:Osteogenic sarcoma associated with Paget's disease of bone. A clinicopathologic study of 65 patients. 657 36

Clinical and morphologic variables in soft-tissue sarcomas and lipomas were retrospectively analysed and compared in consecutive, unselected population-based series from southern Sweden 1964-1981. Among the sarcoma patients these variables and the treatment given were evaluated by multivariate analysis with regard to the clinical course. The results of aspiration cytology and its influence on the choice of surgical procedure were evaluated in two series of patients referred to the Orthopaedic Oncology Group (the Center) because of suspected malignant soft-tissue tumors. Changes in the surgical treatment over time was determined. The annual incidence of sarcoma was 1.4/10(5) with a 30 per cent male preponderance. The mean age was 58 years. The most common histologic types were malignant fibrous histiocytoma, liposarcoma and leiomyosarcoma. Twenty-three per cent were histologically classified as low-grade malignant (Grades I and II), 33 per cent as Grade III and 44 per cent as Grade IV tumors. Slightly more than one half of the tumors were deep and these had a median size of 8 cm compared to 4 cm for the superficial tumors. One third of the tumors were located in the thigh. The annual clinical incidence of solitary subcutaneous lipoma was estimated to 1/10(3). Four fifths of the lipomas were smaller than 5 cm and they were most common in the trunk, shoulder and upper arm. By comparing clinical data for benign tumors and sarcomas it was found that a tumor 5 cm or larger or a deep tumor is relatively more likely to be a sarcoma. Patients with tumors of that size and depth should be referred before surgery. The probability of a benign cytodiagnosis being correct was 0.97 while that of a malignant one was 0.85. For a cytodiagnostic report of sarcoma the probability of correct diagnosis was 0.84. In a prospective evaluation the planned surgery was changed by subsequent cytodiagnosis in one third of the patients. Negative prognostic variables as regards survival in the order of decreasing relative risks were: Malignancy Grades IV and III, pain, male sex, increasing age and tumor size, marginal surgery and extracompartmental tumor site. Marginal excision, extracompartmental tumor site and age exerted their effect only via local recurrence which had a stronger negative influence on survival than any of the other variables. A linear survival function based on the prognostic variables was related to the probability of survival and the patients could be stratified into subsets with significantly different survival.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Management of patients with soft-tissue tumors. Strategy developed at a regional oncology center. 658 79

A retrospective study of 141 cases of clear cell sarcoma of tendons and aponeuroses revealed that the tumor occurred predominantly in young patients between 15 and 35 years of age, was slightly more common in female than in male patients, and originated chiefly from tendons, aponeuroses, and fascial structures of the extremities with a predilection for the feet and knees. The tumor presented as an insidiously growing mass causing pain or tenderness in slightly more than half of the patients. The preoperative duration of symptoms varied greatly, and in 29 cases the time interval between discovery of the tumor and operation exceeded 5 years. Microscopically, the tumors varied little in appearance and were composed of short fascicles of fusiform cells with a clear to granular eosinophilic cytoplasm, vesicular nuclei with prominent nucleoli, and occasional multinucleated giant cells. Melanin was demonstrated in 72% of the 92 tumors in which the Fontana or Warthin-Starry preparation for melanin was performed. S-100 protein, a neuroectodermal marker, was positive in 13 of 19 cases. Follow-up information was available in 115 patients. Thirty-four (29.6%) were alive and well with no evidence of recurrence. Twenty-four (20.9%) patients were alive with one or two recurrences, three (2.6%) were alive following pulmonary lobectomy for metastatic sarcoma, and one was alive with metastasis in the thoracic spine. Fifty-three of the 115 patients with follow-up information had died, 50 from metastatic tumor and three from miscellaneous causes. The prevailing sites of metastasis were the lung and the regional lymph nodes. The exact histogenesis remains obscure, but the presence of intracellular melanin in two-thirds of the cases supports origin from migrated neural crest cells with the capacity for producing melanin. For this reason the term, malignant melanoma of soft parts, seems preferable over the purely descriptive term of clear cell sarcoma.
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PMID:Malignant melanoma of soft parts. A reassessment of clear cell sarcoma. 661 6

A malignant mesenchymoma consisting of nerve sheath sarcoma and liposarcoma occurred in the right median nerve of a 29-year-old man who did not have stigmata of von Recklinghausen neurofibromatosis. It produced pain at the affected part, referred pain to the palm, and weakness of muscles supplied by branches of this nerve. The tumor was first excised 1 month after its initial manifestation, but recurred twice and eventually metastasized to the lung within 19 months. It is suggested that aberrant differentiation of the mesenchymal component of the neural crest, the ectomesenchymal structure, has created this combined sarcoma of nerve sheath and liposarcoma, forming a malignant mesenchymoma.
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PMID:Malignant mesenchymoma of median nerve: combined nerve sheath sarcoma and liposarcoma. 669


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