Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ovarian tumors in the pediatric age group, although rare, can be malignant and lethal; the most common is the germ cell tumor. Operation and chemotherapy with multiple drugs is recommended to improve survival. For children with benign ovarian tumors, preservation of ovarian tissue should be a priority. Thirty children with ovarian tumors were treated at Kosair Children's Hospital in Louisville, Kentucky, over the past 19 years. The average patient age was 12 years. Presenting symptoms were acute pain (46%), chronic pain (33%), increased abdominal girth (21%), and a palpable mass (55%). Plain x-ray films of the abdomen, ultrasonography, and intravenous pyelography were helpful in making the diagnosis preoperatively. Emergency laparotomy for an acute abdominal condition was done in ten patients. Twenty-two tumors were benign and eight were malignant. Of the malignant tumors, six (75%) were germ cell tumors, one was a sex cord tumor, and one was a cystadenocarcinoma. Benign tumors were managed by cystectomy or oophorectomy. For malignant tumors, oophorectomy or salpingo-oophorectomy was done initially, followed by chemotherapy and "second look" procedures. Survival ranged from five months to nine years, with an average of 46 months. Four patients died between five and 40 months after diagnosis; the other four have a median survival of 76 months.
 ...
PMID:Ovarian tumors in children. 283 18

Necrotic testicular tumors are relatively frequent and can present a significant diagnostic challenge. Because of differing treatments for seminomas versus nonseminomas, accurate diagnosis is critical. Eleven totally (n=9) or almost totally (n=2) necrotic testicular tumors were retrieved from our consult files. The submitting pathologists favored benign processes in 4 cases, Leydig cell tumor in 1, and lymphoma in 1. The cases were evaluated for histologic features and, when material was available, by immunostaining with 7 antibodies: keratin (AE1/AE3), OCT4, placental alkaline phosphatase, alpha-fetoprotein (AFP), CD117, CD30, and S100. Only distinct reactivity in a cellular distribution in the necrotic zone was considered positive; nuclear reactivity alone was scored for OCT4 and membrane reactivity for CD117 and CD30. Mean patient age was 35 years (range 16-63). Mean tumor size was 19 mm (range 7-53). All patients presented with unilateral testicular masses (6 right, 5 left); 2 also had acute pain. The combination of histologic features, immunostains and, in 1 case, serum AFP permitted classification of 8 tumors (4 seminomas, 3 embryonal carcinomas, 1 yolk sac tumor). Three were not classifiable. The necrotic seminomas lacked associated coarse intratubular calcifications and were positive for OCT4 (4/4) and CD117 (3/3) but negative for keratin (0/4) and CD30 (0/4). The necrotic embryonal carcinomas had associated coarse intratubular calcifications and were positive for keratin (2/3), OCT4 (2/2), and CD30 (3/3). OCT4 stained 1 unclassifiable tumor, which lacked other specific markers. We did not find placental alkaline phosphatase, AFP, and S100 stains useful, although S100 did highlight tumor "ghost" cells in 1 case. Other features in most cases included intratubular germ cell neoplasia (6/11), tubular atrophy/hyalinization (10/11), tumor "ghost" cells (10/11), scar (9/11), and inflammation (10/11). Of the 5 patients with available follow-up, 3 were free of disease at 1, 5, and 8 years after orchiectomy (2 necrotic seminomas and 1 germ cell tumor, unclassified). One patient with yolk sac tumor (age 63 y) developed widespread metastases after 15 months and died of disease. The final case was initially misinterpreted as "testicular infarction, no malignancy" and 16 months later the patient developed a large retroperitoneal seminoma. Most totally necrotic testicular tumors can be placed into clinically important groups by assessment for coarse intratubular calcifications and staining reactions for keratin, OCT4, CD117, and CD30.
 ...
PMID:The utility of microscopic findings and immunohistochemistry in the classification of necrotic testicular tumors: a study of 11 cases. 1946 7