Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty-five patients with Stage IB adenocarcinoma of the cervix were treated by radical hysterectomy and pelvic lymphadenectomy from 1965 through 1985. Bleeding was the presenting symptom in 56% of the patients. Twenty patients underwent cone biopsy for diagnostic purposes and 70% had residual carcinoma at the time of definitive surgery. A single postoperative death occurred as the result of pulmonary embolism. Tumor size, depth of invasion, and nodal metastases proved to be important prognostic factors. Tumor grade and histologic type were not related to tumor recurrence, although adenosquamous carcinoma was more frequently associated with a greater depth of invasion. Nine patients had nodal metastases, and 78% of patients with spread to the regional nodes developed recurrent carcinoma. Microscopic invasion beyond the cervix or metastases to lymph nodes was present in all but two of the 12 patients with recurrence after surgery. The overall recurrence rate was 22%, with 10 of 12 patients dead of disease, one patient alive with disease, and one patient without evidence of disease. Peritoneal cytologic studies were performed on 22 patients and all had negative cytologic findings. None of the patients with recurrent disease had evidence of intraperitoneal spread. Ninety-one percent of the patients had ovarian preservation, and there is no evidence that this contributed to tumor recurrence.
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PMID:Stage IB adenocarcinoma of the cervix treated by radical hysterectomy and pelvic lymph node dissection. 273 70

Two cases of systemic thromboembolism (Trousseau syndrome) associated with metastatic human papillomavirus (HPV)-related endocervical adenocarcinomas are reported. The first patient, age 36, presented with bilateral lower extremity deep vein thromboses, pulmonary embolism, and supraclavicular and cervical lymphadenopathy. Lymph node biopsy revealed metastatic mucinous adenocarcinoma with focal signet ring cell differentiation. Imaging studies demonstrated metastatic disease without a defined primary site. Acute renal and respiratory failure developed and the patient expired shortly after initiation of chemotherapy, 7 weeks after presentation. Autopsy examination revealed widespread metastatic adenocarcinoma with a 2 cm cervical adenocarcinoma. The second patient, age 43, presented with left internal jugular vein thrombosis, acute thrombophlebitis, and bilateral axillary lymphadenopathy. She developed progressive venous thrombosis despite anticoagulation. Imaging studies demonstrated widespread lymphadenopathy and an adnexal mass. Diagnostic laparoscopy with biopsies and left oophorectomy revealed metastatic mucinous adenocarcinoma with signet ring cell differentiation involving peritoneum, ovary, cervix, and bladder without a defined primary site. Progressive thromboembolic disease with acute renal failure and multiple cerebral infarcts developed and the patient expired shortly after initiation of chemotherapy, 2 months after presentation. No autopsy was performed. HPV DNA was detected by in situ hybridization in the lymph node metastasis in the first case and in the cervical and ovarian tumor specimens in the second case. High-risk HPV-related endocervical adenocarcinomas occasionally exhibit signet ring cell differentiation and can present with Trousseau syndrome. These features more commonly suggest metastatic adenocarcinoma of upper gastrointestinal tract origin but the presence of HPV DNA within the tumors establishes them as cervical in origin.
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PMID:Metastatic HPV-related cervical adenocarcinomas presenting with thromboembolic events (Trousseau Syndrome): clinicopathologic characteristics of 2 cases. 1918 22