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 brief review of cranio-facial fibro-osseous lesions is given and 15 cases of fibrous dysplasia and ossifying fibroma are presented with clinical, radiological and histomorphological findings. After histological verification of the fibro-osseous nature of the process, 5 lesions were diagnosed on an radiological basis as fibrous dysplasia exhibiting diffuse (blending) margins, while the diagnosis of ossifying fibroma was given to 10 radiologically sharply-demarcated lesions. Both groups of lesions presented the same histomorphological features, although to a varying degree. Spheroidal calcifications, however, were identified in ossifying fibroma only, but not in all of these. Thus, the differential diagnosis of fibrous dysplasia versus ossifying fibroma rests on a radiological criterion after the histopathologist has verified the fibro-osseous nature of a lesion. The observation times varied from 1 1/2 to 34 years. Two cases of fibrous dysplasia and 3 cases of ossifying fibroma recurred. In one case of fibrous dysplasia an osteosarcoma developed 33 years after irradiation. Pain was a common symptom in the present material.
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PMID:Fibro-osseous lesions of the cranio-facial bones. 11 98

A histologically confirmed malignant, primary bone tumour in the pelvis, presumably an osteosarcoma, underwent spontaneous regression. The large tumour was inoperable and gave rise to severe pain as well as difficulty in walking. After 2 years of progression, with increasing desition improved spontaneously, and at present the patient is alive, almost symptom-free, after 6 years follow-up.
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PMID:Spontaneous regression of a malignant primary bone tumour. 27 96

Twenty-nine patients, 27 of them with osteosarcoma and two with juvenile laryngeal papilloma, were followed for an aggregate period of 365 months, during which time they received long-term treatment with human leukocyte interferon. The interferon was given by intramuscular injection either daily or three times a week; the dose was 3 x 10(6) standard units. During the course of the treatment, 12 distinct symptoms were recognized as possible side effects of the drug; the three most frequent symptoms occurring after injection were fever, local pain, and shivering. All but three of the patients reported between one and five symptoms. Partial purification of the interferon reduced or eliminated some, but not all, of the symptoms. All of the patients were treated on an ambulatory basis, and none had to discontinue the interferon therapy because of the side effects.
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PMID:Side effects of long-term treatment with human leukocyte interferon. 29 35

An accurate pathological diagnosis must be made prior to treatment of a primary malignant bone tumour. Consideration must be given to the clinical and radiologic aspects as well as the histology. Both benign and malignant tumours occur more frequently in certain decades. A search should be made for precursor lesions such as Paget's disease. The presenting manifestations of pain, a mass and dysfunction are not specific for tumours. Laboratory tests may be helpful, especially in distinguishing tumours from infections and metabolic diseases. Metastasis is usually via the blood stream to the lungs and bones. The low survival rate following amputation for osteosarcoma and radiation therapy for Ewing's sarcoma has been improved by chemotherapy. The lower-grade tumours such as aggressive giant cell tumour and low-grade chondrosarcoma can often by treated successfully by resection and insertion of an autograft, an allograft or a metallic implant.
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PMID:Malignant tumours of bone: clinical aspects and natural course. 33 30

Primary bony and cartilaginous sarcomas of the chest wall are uncommon, and data concerning treatment and results are sparse. To assess the results of therapy, we reviewed our 40-year experience. Records of 38 patients with osteosarcoma and 88 with chondrosarcoma arising in chest wall admitted to Memorial Sloan-Kettering Cancer Center from 1949 to 1989 were reviewed. The 88 patients with chondrosarcoma ranged in age from 5 to 86 years (median age, 49 years); the male/female ratio was 1.3:1. Presenting complaint was mass, pain, or both in 93%. Primary therapy was resection (n = 84), radiation therapy (n = 3), or chemotherapy (n = 1). Overall 5-year survival was 64%. Significant adverse prognostic factors included metastases at initial presentation (n = 9), metastases at any time during the course of disease (n = 23), age greater than 50 years (n = 42), incomplete or no resection (n = 13), and local recurrence (n = 24). Sex, grade, and tumor size were not prognostic factors. The 38 patients with osteosarcoma ranged in age from 11 to 78 years (median age, 42 years); the male/female ratio was 1.5:1. Presenting complaint was mass, pain, or both in 95%. Primary therapy included resection (n = 31; alone in 13, with radiation therapy in 3, with chemotherapy in 15), radiation therapy (n = 3), radiation therapy and chemotherapy (n = 2), chemotherapy (n = 1), or no treatment (n = 1). Overall 5-year survival was 15%. Significant adverse prognostic factors included presence of synchronous metastases (n = 13) and metastases at any time during the course of disease (n = 26).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Primary bony and cartilaginous sarcomas of chest wall: results of therapy. 163 9

A case is presented of an 18-year-old women who suffered pain and swelling after intraarterial cisplatin chemotherapy for osteosarcoma of the left fibula. Radiological studies showed minimal changes at the metadiaphyseal portion of the left tibia. Bone scans and MR studies were highly suggestive of necrosis of bone and muscle of the proximal end of the tibia. Multiple biopsies of the tibia at the time of excision and 2 years later showed histological features consistent with a slowly healing osteonecrosis of bone. Review of the literature reported transient pain and swelling after intraarterial chemotherapy but did not demonstrate the association with necrosis of bone and muscle. It can be anticipated that as intraarterial chemotherapy of malignant tumors of bone and soft tissues becomes more widely used, these complications will be observed more frequently.
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PMID:Case report 669: Osteonecrosis of bone associated with intraarterial therapy using cisplatin. 185 24

Postirradiation and Paget's osteosarcomas are high-grade malignancies. The five-year survival was only 10% in recent experience at the author's institution. Progressive pain is an important clinical feature in both conditions. Careful roentgenographic studies demonstrate cortical destruction and a soft-tissue mass in virtually all patients. Metastasis was present in 25% of both groups of patients at presentation. In contrast to previous series, more than 80% of the patients with postirradiation osteosarcoma had had irradiation for malignant entities and more than 70% had been treated with modern radiotherapy regimens (cobalt-60 or linear accelerator). Twice as many patients with postirradiation osteosarcoma were evaluated and treated in the 1980s than in the previous decade. The initial indication for irradiation often was carcinoma of the breast, uterus, or cervix, or lymphoma. Two-thirds of the patients had progressive disease that was not controllable within six months after diagnosis. Early detection may be the only effective means of improving survival with postirradiation or Paget's osteosarcoma. These patients require lifelong follow-up evaluations.
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PMID:Survival and management considerations in postirradiation osteosarcoma and Paget's osteosarcoma. 188 30

The clinical, radiologic, and histologic features of 22 cases of Paget sarcoma were reviewed to determine in which patients with Paget disease these tumors are most likely to develop and what radiologic findings suggest the diagnosis. Clinical findings at presentation included pain and/or a mass (11 patients), pathologic fracture (seven), and neurologic symptoms (four). Survival time in 20 patients ranged from 5 days to 2.5 years. Two patients were lost to follow-up: one at 2 years and one at 8 years. There were 16 high-grade osteosarcomas, three chondrosarcomas, two fibrosarcomas, and one malignant fibrous histiocytoma. The most common site was the femur. Tumors also were observed in unusual sites. In one case of multifocal osteosarcoma, the tumor involved only pagetic bone. In 15 patients, Paget disease was polyostotic, clinically significant, and had been documented previously. In four patients, a sarcoma developed near the site of a fracture that had occurred between 2 months and 15 years previously. All cases showed radiologic evidence of a destructive lesion; other findings included a mass and evidence of tumor mineralization. Periosteal reaction was not observed. All but one tumor developed in a site of osteoblastic or mixed osteoblastic and lytic Paget disease. Our results suggest that sarcomas can develop in any part of any bone affected by Paget disease but are more likely to occur with advanced disease and to present with a destructive lesion without periosteal reaction.
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PMID:Sarcoma in Paget disease of bone: clinical, radiologic, and pathologic features in 22 cases. 202 67

Excluding multiple myeloma, osteosarcoma is the most frequent primary malignant bone tumor. However, it is rare in the jaw bones, where it mainly occurs in young adult men. This report describes two mandibular osteosarcomas found in two males aged 32 and 30. In the former patient, osteosarcoma developed after bilateral mandibular sclerotic changes had been diagnosed radiologically as cementifying fibroma. This patient had received radiation therapy (56 Gy) because of a high grade astrocytoma of the brain three and a half years earlier. In the latter patient the tumor arose de novo in the mandibular molar area. The initial main symptom both patients was pain, which had been considered to be of dental origin because radiographs showed no evidence of malignancy. Radical surgery using immediate mandibular reconstruction with revascularized iliac bone grafts gave good results in both cases. The former patient died eight months after surgery because of recurrent astrocytoma and the latter is now free of disease five years after surgery. Immediate reconstruction of mandibular defects is possible with osteocutaneous groin flaps.
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PMID:Immediate reconstruction of mandibular defects with revascularized iliac bone grafts after radical surgery for osteosarcoma. 209 48

Based on 57 fibrous metaphyseal defects the conventional radiologic signs are described as diagnostically reliable including asymptomatic patients as well as patients with a history of pain and lesions with positive scintigraphy. The radiologic morphology of the fibrous endosteal and medullary defects differs with the age of the patient. Beyond the age of 18 years there is a sclerosis of the lesion and a less marked arrosion of the corticalis. The differential diagnosis depends on the cortical, endosteal of medullary site of the fibrous defect as well as on the age of patient and includes the cortical metastasis, the juxta-articular osteoid-osteoma, the periosteal chondroma, the cortical irregularity, the solitary bone cyst, the fibrous dysplasia, the chronic osteomyelitis and the osteosclerotic osteosarcoma.
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PMID:[Fibrous metaphyseal defect--a stage- and age-dependent differential diagnosis]. 216 74


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