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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During a 10-year period 21 patients were treated for tumors of the heart, including 19 myxomas, one fibroma, and one sarcoma. The latter two cases are presented separately, and the 19 myxomas are analyzed together. An unusual association of left-sided myxoma with mitral valve abnormalities was found. In the surgical group (18 patients) there were no deaths and one case of postoperative cerebrovascular accident (CVA) with residual sequelae during a mean follow-up of 55 months. The results show the good prognosis of patients operated upon for myxomas of the heart and that there is no need for routine full-thickness excision of the septum in its treatment.
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PMID:Primary tumors of the heart: a rewarding challenge. 51 66

Theories on the nature of cancer may be classified into two categories. One regards cancer strictly as a local phenomenon while the second looks at cancer as a local manifestation of a systemic process or disease. Although the first dominates current medical thought, the theories of immunological surveillance and of protovirus-oncogene implicitly assume cancer to represent a local manifestation of a systemic process or disease. This is supported also by epidemiological data forwarded in the present paper. In order to clarify the exact meaning of a systemic disease, cancer and its manifestation are compared with arteriosclerosis and its sequelae. Arteriosclerosis could be regarded as a prototype of a systemic disease. It presents itself clinically solely by its local manifestations, like myocardial infarction or stroke. These local manifestations may be followed by secondary systemic sequelae like congestive heart failure. In the same context, it is proposed to regard cancer as one systemic disease which presents itself clinically by local phenomena like carcinoma, lymphoma and sarcoma. These local manifestations may lead further to secondary systemic sequelae like metastasis.
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PMID:Cancer as a systemic disease. 67 9

Acute changes in mental status (AMS) develop in children with cancer from a multitude of cancer- and treatment-related complications. To determine the incidence, etiology, and outcome of children with cancer who had AMS, the medical records of all children under 18 years of age with systemic cancer (excluding primary central nervous system tumors) who had AMS in our institution during the years 1981 through 1987 were reviewed. AMS developed in 89 of 815 children at risk (11%). The AMS was caused by seizures in 53 (60%), an encephalopathy in 24 (27%), and a stroke syndrome in 12 (13%). AMS occurred in 42 of 305 (14%) with leukemia, 16 of 139 (12%) with lymphoma, 14 of 136 (10%) with sarcoma, 10 of 104 (9%) with neuroblastoma, and 7 of 104 (5%) with other malignancies. Children with acute lymphocytic leukemia were more prone to having seizures (61%), while children with nonacute lymphocytic leukemia were almost equally likely to have encephalopathies, strokes, or seizures. Children with lymphoma were admitted for treatment most often with an encephalopathy (44%). Etiologies for AMS were evaluated vigorously, and one or more etiologies were identified in 80 of 89 (89%) patients. Dependent on the type of tumor, the anticancer treatment used and, timing during the course of illness AMS occurred, specific diagnoses were more likely. Neurologic morbidity and mortality were dependent on the cause of AMS. Children with seizures that were initially difficult to control were more likely to require long-term anticonvulsant therapy.
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PMID:Acute mental status changes in children with systemic cancer. 230 89

A major right hemispheric infarct developed in a 31-year-old man within forty-eight hours of lung resection for metastatic synovial-cell sarcoma. Post mortem exam revealed tumorous occlusion of the right internal carotid artery. Major stroke from cerebral tumor embolus should be seriously considered in patients with primary or metastatic lung cancer who have had a very recent pneumonectomy, especially when there are symptoms and signs of multi-organ or extremity ischemia.
Stroke
PMID:Major cerebral infarction from tumor embolus. 301 31

To determine the maximum tolerated dose (MTD) of escalating doses of interferon-alpha-2b (IFN, Intron A) with 5-fluorouracil (5-FU) and cisplatin (DDP) in patients with advanced cancer, 15 patients were accrued between May 1990 and July 1991. Primary sites were unknown (3), colorectal (3), head and neck (2), lung (2), gynecologic (1), gallbladder (1), sarcoma (1), anal canal (1) and pancreas (1). IFN was given s.c. on days 1-5 and then three times weekly with DDP (75 mg/m2, day 1) and 5-FU [750 mg/m2, days 1-5, continuous infusion (CI) on a 28-day cycle. The first two patients treated at level I (3 x 10(6) U/m2 s.c.) experienced possible neurotoxic deaths [massive cerebrovascular accident (CVA) and metabolic encephalopathy], and patient 3 had a grade 4 toxicity of performance status decline. Analysis of these events led us to exclude the enrollment of patients on i.v. morphine and of those with prior exposure to DDP. This resulted in grade 3 toxicity in terms of nausea, vomiting, fatigue and leukopenia but in no further CNS event. All patients were evaluable for toxicity but only ten were evaluable for response. Only two partial responses were seen, one in a patient with an unknown primary tumour and one in a patient with head and neck cancer. The combination of IFN is possible with 5-FU and DDP. The recommended dose of IFN is 2 x 10(6) U/m2 s.c. in patients with no prior exposure to DDP or i.v. morphine, given together with 5-FU (750 mg/m2, days 1-5, CI) and DDP (75 mg/m2, day 1) on a 28-day cycle.
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PMID:A phase I study of recombinant human interferon alpha-2b combined with 5-fluorouracil and cisplatin in patients with advanced cancer. 788 58

Stroke are not as rare in pediatric patients as once suspected. Exhaustive diagnostic evaluation must be performed, to identify a cause, evaluate risk factors of recurrence and propose preventive treatment. We report a case in a teen-ager secondary to cerebral embolism. These embols have an exceptional origin: pulmonary venous thrombosis, secondary to undifferentiated sarcoma located in the lung and extended to pulmonary vein. Stroke by cerebral embolism are not always originated from heart disease, and may be misdiagnosed only transthoracic echocardiography is realised.
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PMID:[Vascular complication disclosing lung cancer in children]. 899 Nov 78

A case of radiation-induced sarcoma of the chest wall is reported. Twenty-seven years 11 months after orthovoltage radiotherapy of the right breast a 69-year-old woman developed a radiation-induced osteosarcoma of the right thoracic wall. Initial diagnosis has been T-cell lymphoma of the skin. The right breast was irradiated with tangential fields and a total dose of 40 Gy, 2 Gy/day, 5 days a week. Orthovoltage treatment was performed in two courses of 20 Gy, 3 months apart. The clinical appearance of the secondary sarcoma was a diffuse infiltrated area in the irradiated breast which seemed to be fixed to the chest wall. Magnetic resonance imaging (MRI) demonstrated a mass in the right anterior thoracic wall which destroyed the fourth to the sixth rib. The tumor infiltrated the thoracic wall, including subcutaneous tissue and pericardium, as well as extending into the subphrenic space. Biopsy of the lesion revealed a poorly differentiated osteosarcoma. The patient's general condition precluded surgical or chemotherapeutic intervention; she died due to a cerebral stroke 6 months later. This case fulfilled all criteria for radiation-induced sarcoma, as there was a prior history of radiotherapy, latency period of several years, development of sarcoma within the irradiated field, and histologic confirmation of sarcoma.
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PMID:Radiation-induced osteosarcoma of the chest wall. 1219 65

The unusual case of an exclusively intracranial localization of fasciitis (CF) in a man aged 47 is reported. The cystic lesion had been accidentally discovered 10 years before when the patient sustained a contralateral ischemic stroke; the cyst, being absolutely silent, was not operated on at that time. After 10 years, the patient complained of seizures and mild right-sided paresis. CT scan revealed a dramatic increase of the lesion whose mass effect caused an initial subfalcial herniation of the brain. The mass was grossly removed, the patient recovered and become seizure-free. CF, rare in childhood, is exceptional in the adult age. The importance of a correct histological diagnosis is hereby stressed, because CF is absolutely benign, self-limiting, and does not require further treatment, but may be misdiagnosed as sarcoma.
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PMID:Exclusively intracranial and cranial fasciitis of the adult age. 1244 22

Although cardiac tumors are rare, they nevertheless represent an important subgroup, the diagnosis of which is challenging for the primary care physician. Symptoms are not characteristic and serious complications including stroke, myocardial infarction and even sudden death from arrhythmia may be the first signs of tumor. The most common primary cardiac neoplasm is the benign myxoma and the most frequent primary malignant lesion is sarcoma. Cardiac metastases from distant primary carcinomas are now frequently encountered. Echocardiography until the past decade was the only consistently reliable and available non-invasive diagnostic tool. New non-invasive CT and MRI exams are changing the diagnostic approach. Echocardiography and angiocardiography with or without coronary arteriography remain routine methods for evaluating cardiac neoplasms. However, CT provides additional diagnostic information and is regarded as essential for adequate staging and treatment planning, particularly when surgical resection is being considered. This chapter reviews the wide spectrum of intracardiac thrombi and tumors including their incidence and imaging characteristics with particular reference to the CT findings and differential diagnosis.
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PMID:CT for intracardiac thrombi and tumors. 1591 45

A 50-year-old woman presented with subacute cognitive decline, impaired eye movements, and simultanagnosia, components of the Balint syndrome. She had relatively low blood pressure in the left arm and left finger clubbing. Brain imaging identified multiple acute infarcts. Transesophageal echocardiography showed no cardiac abnormalities but demonstrated a thickened aortic wall and an intraluminal aortic arch mass. The surgical specimen revealed angiosarcoma. Of the few reported angiosarcomas involving the aorta, most have been located in the abdominal segment. This is only the second reported case of aortic arch sarcoma presenting with stroke.
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PMID:Multiple brain infarcts and Balint syndrome in aortic arch angiosarcoma. 1684 10


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