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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Documented rarity, diagnostic difficulty and poor results stimulated this study of 79 malignant and 37 benign small bowel tumors in order to emphasize these lesions, determine their symptomatology and improve diagnosis and results, particularly in the malignant group. Chief symptoms were recurrent abdominal pain and tenderness, signs of obstruction and gastrointestinal bleeding. Fourteen cases were asymptomatic. The mean symptom-diagnosis interval was 6.6 months. Roentgenographic contrast studies were helpful in diagnosing 33 of 43 patients, with false negatives in 10. Laboratory studies were usually not helpful. Metastases were present at the time of surgery in approximately 58%. In the malignant group curative procedures were performed in 36 and palliative in 43, with an operative mortality of 10%. Five and 10 year survival rates were respectively 21/51 (41.2%) and 8/38 (21.2%) for malignancies. Individual 5 and 10 year survival rates were respectively as follows: carcinoid 11/15, 4/8; undifferentiated carcinoma 3/5, 1/3; lymphoma 3/11, 1/9; leiomyosarcoma 2/7, 1/6 and adenocarcinoma 2/13, 1/12. In the benign group results were excellent, except for one death from pulmonary embolism. The study suggests that if results with malignant small bowel tumors are to be improved, prompt diagnostic study and early consideration of laparotomy in patients with suggestive symptoms is mandatory.
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PMID:The small bowel tumor problem: an assessment based on a 20 year experience with 116 cases. 45 45

Successful resection of a pulmonary artery leiomyosarcoma was performed in a patient with clinical features of chronic pulmonary embolism. With radical radiotherapy to the mediastinum and solitary right hip metastasis, the patient remained well 6 months later. The difficulty of accurate diagnosis is considered in the light of recent advances in the techniques of cardiac investigation.
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PMID:Leiomyosarcoma of the pulmonary artery. 157 Sep 96

On the basis of one personal case of leiomyosarcoma, the various anatomicoclinical features of sarcomas of the pulmonary artery are summed up. They most often produce a picture of severe pulmonary embolism that is resistant to all treatments; the lesion most often is a hilar mass without any associated bronchoscopic abnormality. Angiograms are not always easily interpreted, and the modern imaging techniques (ultrasound, computed tomography, and above all MRI) can best lead to the preoperative diagnosis, although this lesion is unfrequent.
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PMID:[Primary sarcoma of the pulmonary artery]. 175 65

A case of leiomyosarcoma of the pulmonary artery in a 64-year old man without previous cardiovascular disease is reported. The clinical picture, which comprised episodes of paroxysmal dyspnoea associated with acute cor pulmonale, suggested pulmonary embolism. Radioisotope perfusion study and pulmonary angiography seemed to confirm this diagnosis, but no improvement was obtained with a prolonged thrombolytic treatment. The presence of a median mass at CT led to exploratory thoracotomy and to the finding of a tumour in the pulmonary artery, which turned out to be a leiomyosarcoma. The disease rapidly took an unfavourable course. Comparison of this case with data from the literature showed that primary tumours of the pulmonary artery are extremely rare, that they are diagnosed with difficulty and often at a late stage and that their prognosis is usually very sombre.
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PMID:[Primary leiomyosarcoma of the pulmonary artery. Apropos of a case]. 312 93

The treatment of a massive or fulminant pulmonary embolism (PE) occurring in the early postoperative phase by embolectomy or fibrinolysis with streptokinase (SK) or urokinase (UK) differs with regard to success and mortality. Embolectomy has a higher mortality and is not practicable in every hospital. Fibrinolysis differs according to substance (SK or UK), dosage, and duration. Five days after extirpation of a leiomyosarcoma--located retroperitoneally in the pelvis--a 72-year-old woman had a massive PE (scintigraphy diagnosis) (Fig. 1). On PEEP-breathing, nitroglycerin (66 micrograms/min), and dobutamin (416 micrograms/min), paO2 and SaO2 showed an increasing tendency, but 4 days after the diagnosis of PE--on the 8th postoperative day--paO2 and SaO2 dropped again (Fig. 3). Fibrinolysis was undertaken with 1.5 million units of SK over a period of 40 min through a Swan-Ganz catheter located in the pulmonary artery. A few hours after the fibrinolytic treatment, paO2 increased at a significant rate and FIO2 could be markedly reduced from 0.7 to 0.4. Twenty-four hours after SK lysis the pulmonary artery pressure (PAP) had still not decreased, but the cardiac output (CO) showed an increasing tendency. The scintigraphic control 17 days after the diagnosis of PE (Fig. 2) correlated with the clinical parameters. The patient was discharged. High-dose ultra-short fibrinolysis with SK in the early postoperative period is discussed in connection with efficiency and bleeding complications ("plasmin-lysis" versus "activator-lysis").
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PMID:[High-dose short time fibrinolytic treatment with streptokinase of massive lung embolism in the early postoperative period]. 363 91

Primary pulmonary trunk sarcoma is a rare and highly lethal disease. A case of multicentric pulmonary trunk leiomyosarcoma with right and left main pulmonary artery involvement, mimicking massive pulmonary embolism, is described. The importance of a timely diagnosis and of radical surgical excision is discussed.
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PMID:Primary leiomyosarcoma of the pulmonary artery: diagnostic and surgical implications. 827

A patient with clinical features consistent with pulmonary embolism showed no improvement despite therapy with tissue-plasminogen activator and full-dose heparin. Transvenous catheter suction biopsy was successful in establishing an antemortem histologic diagnosis of primary pulmonary artery leiomyosarcoma. Urgent surgical intervention was performed.
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PMID:Primary leiomyosarcoma of the pulmonary artery confirmed by catheter suction biopsy. 949 86

Pulmonary artery leiomyosarcoma is a rare but highly lethal disease, and can be mistaken for pulmonary thromboembolism. We report a case of pulmonary artery leiomyosarcoma managed with surgical resection, chemotherapy, and radiotherapy. A 57-year-old woman was admitted with complaints of aggravated dyspnea. She was initially treated with oxygen therapy and heparinization for a suspected pulmonary embolism. Echocardiography revealed a dilated right atrium and ventricle and severe tricuspid regurgitation, with an estimated systolic right ventricular pressure of 95 mm Hg; a shadow of a mass in the main pulmonary artery was also noted. Right ventriculography revealed a filling defect, and to-and-fro motion of the mass in the main pulmonary artery. The left pulmonary artery was almost totally occluded by the mass. The patient's condition improved dramatically after palliative excision of the mass and patch reconstruction of the outflow tract of the right ventricle with a bicuspid xenograft. Pathologic examination of the mass revealed leiomyosarcoma. Chemotherapy and radiotherapy were subsequently administered and follow-up imaging studies 3 months postoperatively revealed no recurrence of the tumor. The patient remains well, more than 1 year after treatment. This report emphasises that pulmonary artery sarcoma should be considered in the differential diagnosis in cases of suspected pulmonary thromboembolism.
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PMID:Pulmonary artery leiomyosarcoma. 1050 13

Abdominal tumors that can grow through vascular lumen and spread to the right heart are rare. Although these tumors have different histologic aspects, they may cause similar abdominal and cardiac symptoms and are a serious risk factor for pulmonary embolism and sudden death when they reach the right atrium and tricuspid valve. The best treatment is radical surgical resection of the entire tumor using cardiopulmonary bypass with or without deep hypothermia and total circulatory arrest. We report the cases of two patients, the first with leiomyosarcoma of the inferior vena cava and the other with intravenous leiomyomatosis of the uterus that showed intravascular growth up to right atrium and ventricle, who underwent successful radical resection in a one-stage procedure with the use of cardiopulmonary bypass. We discuss the clinical and histologic aspects and imaging diagnosis and review the literature.
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PMID:Unusual abdominal tumors with intracardiac extension. Two cases with successful surgical resection. 1078 38

Primary Cardiac leiomyosarcoma is a very rare condition. The authors report the case of a 64 year old woman admitted to hospital for suspected pulmonary embolism, confirmed by thoracic angio-CT scan. Despite thrombolytic therapy, a persistent poor haemodynamic condition associated with a superior vena cava syndrome led to a transoesophageal echocardiographic examination which demonstrated an abnormal intra-right atrial mass obstructing the tricuspid valve. At surgery, a leio-myosarcoma was successfully resected under good conditions. During systematic three-monthly clinical and echocardiographic follow-up, transoesophageal echocardiography detected an asymptomatic local recurrence at 15 months, for which surgery was repeated with adjuvant chemotherapy.
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PMID:[Primitive leiomyosarcoma of the right atrium presenting with a pulmonary embolism]. 1083 98


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