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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of lung cancer manifested as cardiac tamponade was reported. A 64-year-old male had anterior chest pain and dyspnea. A chest X-ray films showed an enlarged heart with a solitary round shadow in the left lung hilus. Echocardiogram disclosed a large amount of pericardial effusion. Emergency pericardiectomy with drainage was accomplished. The patient lived for 8 months without effusion accumulation. Histologically adenocarcinoma of the lung with prominent lymph nodes metastases was disclosed. Surgical decompression such as pericardiectomy or pericardial fenestration is a valuable selection in the treatment of pericardial effusion and tamponade.
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PMID:[Lung cancer manifested as cardiac tamponade: a case report]. 747 96

Traditionally, superior vena cava syndrome (SVCS) has been recognized as an oncologic emergency, and with clinical suspicion of the syndrome, tissue diagnosis was often delayed due to possible complications in diagnostic procedures and immediately threatening of life. Previously, local radiotherapy was regarded as the best immediate strategy for management of the condition. We have analyzed 54 lung cancer patients with SVCS in the past 6 years. Our results show that dyspnea (34 cases, 63%) and facial swelling (29 cases, 54%) are the two most common symptoms. The most frequent physical finding was venous distension of the neck (35 cases, 65%). The chest X-ray findings also showed a large ratio of superior mediastinal widening (26 cases, 48%). Fine needle aspiration of palpable lymph node (20 cases, 37%) and trans-thoracic needle aspiration guided by ultrasound (US) (8 cases, 14%) made diagnosis of at least half of the cases possible (28 cases, 51%). Both of these procedures are safer and easier than other invasive methods of examination. Of the 54 patients, small cell carcinoma constituted the majority of the cases (23 cases, 43%) and, with combination chemotherapy, there was a good response rate and a longer survival time (7.4 months) as compared to that of non-small cell carcinoma (3.7 months) treated by radiotherapy. We conclude that lung cancer with SVCS could be quickly and safely diagnosed by needle aspiration of the palpable lymph node or trans-thoracic needle aspiration guided by US, and that with combination chemotherapy the SVCS in small cell carcinoma can be effectively relieved.
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PMID:Superior vena cava syndrome in lung cancer: an analysis of 54 cases. 749 37

A total of 458 eligible patients, from 21 centres, with microscopically confirmed SCLC were allocated at random to three chemotherapy regimens, each given at 3-week intervals. In two regimens, etoposide, cyclophosphamide, methotrexate and vincristine were given for a total of either three courses (ECMV3) or six courses (ECMV6). In the third regimen, etoposide and ifosfamide were given for six courses (E16). Patients with limited disease also received radiotherapy to the primary site after the third course of chemotherapy in all three groups. As reported by clinicians, 59% of the ECMV3, 67% of the ECMV6 and 63% of the EI6 patients experienced moderate or severe adverse reactions to their chemotherapy. The major symptoms of disease, cough, haemoptysis, chest pain, anorexia, and dysphagia, were palliated in 63% or more of patients and the median duration of palliation was 63% or more of survival, the results being similar in the three groups. Among patients with poor overall condition, physical activity and breathlessness on admission, the proportions who improved were higher in the EI6 group but the differences were small. In all three groups, levels of anxiety fell substantially during treatment. Levels of depression were lower and showed little change. As assessed by patients using a daily diary card, the patterns of nausea, vomiting, activity and mood, associated with courses of chemotherapy were very similar in the three groups. In the EI6 group there was less dysphagia and better overall condition between courses, but these advantages need to be weighed against the inconvenience of the 24-h infusions required, compared with the 30-min infusions of the other two regimens. As reported in the companion paper (MRC Lung Cancer Working Party, 1993a) there was no statistically significant survival advantage to any of the three regimens, although the results do not exclude the possibility of a minor survival advantage with the two six-course regimens. In conclusion, there was no major clinical gain from continuing chemotherapy beyond three courses or from using the ifosfamide regimen.
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PMID:A randomised trial of three or six courses of etoposide cyclophosphamide methotrexate and vincristine or six courses of etoposide and ifosfamide in small cell lung cancer (SCLC). II: Quality of life. Medical Research Council Lung Cancer Working Party. 750 4

Prediction of survival can be relevant in palliative care in those units with selective admission policies and limited resources, for planning patient management and in discharge planning for those patients expected to go home. In this study, factors most predictive of prognosis were identified. Those factors shown to have no effect on survival included the performance of investigations or procedures, anti-cancer therapy, morphine dose on admission and original admitting ward. Patients admitted primarily for pain control had a significant survival advantage over those patients admitted for palliation of some other symptom. Actual survival correlated well with predicted outcome. Factors most predictive of relative risk of death in a multivariate analysis were dyspnoea, decubitus ulcers, predicted outcome, interventions and a diagnosis of lung cancer. When symptoms alone were analysed, dyspnoea and immobility carried the highest relative risk of death.
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PMID:Prediction of survival in a hospital-based continuing care unit. 751 31

An 18-year-old man was admitted to our hospital with high temperature and dyspnea. A chest radiograph revealed the presence of multiple round nodules compatible with a metastatic lung cancer. The peripheral white blood cell count was 22,000/mm3 and more than 85 percent were atypical large lymphocytes with azurophilic granules. He was diagnosed as having natural killer (NK)-cell granular lymphocyte proliferative disorder (NK-GLPD) as the lymphocytes were positive with CD56, a cell surface marker characteristic for NK cells. The major pathologic finding of the tissue collected from the pulmonary nodules by transbronchial lung biopsy was infiltration of mostly large granular lymphocytes.
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PMID:Multiple pulmonary nodules manifested in a patient with NK cell granular lymphocyte proliferative disorder. 751 79

In the period from 1983-1991 133 patients (102 men, 31 women) with lung cancer were treated in our pain clinic for 8083 days. Pain was associated with tumour infiltration in 86% of patients and related to therapy in 15%. Even in 6 of 8 patients who were admitted with a diagnosis of "postthoracotomy syndrome" and in all 4 patients with "postradiation syndrome" local recurrence was diagnosed during follow-up. All 17 cases of brachial plexus lesions were caused by local tumour spread. Symptomatic treatment according to WHO guidelines resulted in good pain relief in 92% of patients and on 82% of days. The incidence of dyspnea decreased from 51% of the patients to 16%. Strong opioids were used on 56% of treatment days. Parenteral or spinal administration of opioids was necessary on 3% of days only.
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PMID:[Pain assessment and therapy in bronchial carcinoma]. 752 65

In April 1988 the Christie Hospital started using the microSelectron-HDR machine to deliver intraluminal radiotherapy (ILT) to inoperable bronchial carcinomas causing symptoms due to endobronchial disease. Results of treatment in the first 406 patients with primary non-small-cell carcinoma are presented. Three main categories of patient were defined. Category 1 consisted of 324 patients (79.8%) who were previously unirradiated and received a single fraction of ILT as their primary treatment, mostly to a dose of 1500 cGy (76%) or 2000 cGy (23%) at 1 cm from the centre of the iridium-192 treatment source. The percentage of these patients whose symptoms or signs were improved at 6 weeks following ILT were as follows: stridor 92%, haemoptysis 88%, cough 62%, dyspnoea, 60%, pain, 50% and pulmonary collapse, 46%. Approximately two-thirds of these patients (67.3%) derived long lasting palliation and required no further treatment during their lifetime. The other third of patients needed subsequent treatment at some stage because of recurrence of their symptoms and in this situation external beam radiotherapy (EB) or a repeat ILT treatment was effectively utilised. Category 2 consisted of 65 patients (16%) who had previously received EB but required ILT when their tumour recurred. At 6 weeks post-ILT levels of symptom palliation were broadly similar to those obtained if ILT was used in previously unirradiated individuals, although the improvement was not so well sustained with time and only 7% showed improvement in pulmonary collapse at 6 weeks. Category 3 consisted of 17 patients (4.2%) in whom ILT was used concurrently with EB as a combined initial treatment. Similar levels of palliation were seen when compared with patients who received a single ILT treatment only. Overall, ILT was well tolerated in terms of early and late morbidity. In conclusion, the efficiency of a single ILT treatment in palliating symptoms due to endobronchial tumour in previously unirradiated individuals is comparable with that reported in series where treatment for advanced lung cancer combines a prolonged course of EB concurrently with several ILT treatments.
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PMID:High dose rate intraluminal radiotherapy for carcinoma of the bronchus: outcome of treatment of 406 patients. 753 4

Up to 85% of patients with bronchogenic carcinoma are inoperable at the time of diagnosis and treatment remains largely palliative. Prognosis depends on the clinical tumor stage. In non-small cell carcinoma the clinical stages (I-IV) are defined according to the TNM classification, whereas in small cell carcinoma limited disease is distinguished from extensive disease. Neither classification accurately takes endobronchial tumor spread into account. At the time of diagnosis up to 30% of all lung cancer patients present with central airway obstruction and clinical signs of dyspnea, atelectasis and pneumonia. Most patients with central airway stenosis have inoperable tumors (stage IIIb and IV) and have until recently undergone conventional treatment consisting exclusively of chemo- and radiotherapy. Currently the best results are obtained with combined chemoradiotherapy. The rapid developments in the area of endobronchial treatment modalities enable us to relieve bronchial obstructions fast and safely. This achieves immediate symptomatic relief which in many cases is a precondition for starting chemo- or radiotherapy. Successful reopening of a major airway helps to prolong local tumor control and thus survival. Patients with inoperable lung cancer and obstruction of central airways should undergo initial endobronchial therapy followed by conventional chemo-radiotherapy.
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PMID:[Combination endobronchial and conventional therapy possibilities in inoperable central lung tumors]. 753 48

Contrary to the issues of perioperative morbidity and survival following surgery for lung cancer, little attention has been given to quality-of-life. To address this, quality-of-life was assessed preoperatively and 1, 3, 6 and 9 months postoperatively in a cohort of 117 consecutive subjects who underwent thoracotomy with a certain or presumptive diagnosis of lung cancer. Those with cancer (n = 91) confirmed at thoracotomy were contrasted to those without (n = 26). Moderate to severe dyspnea, reported in 14% preoperatively, increased to 34% at 1 and 3 months (p < 0.005) but returned to approximately 10% at 6 and 9 months. Similarly, activities of daily living were impaired in 11% preoperatively; this disability increased to 21% at 1 month (p < 0.005), and returned to baseline at 6 and 9 months. Those with cancer compared to those without a postoperative diagnosis of cancer had similar quality-of-life preoperatively but deteriorated more in the postoperative period. This study demonstrates that important deterioration in quality-of-life occurs during the first 3 months postoperatively in those with a final diagnosis of cancer but improvement back to baseline can be expected thereafter.
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PMID:Quality-of-life following thoracotomy for lung cancer. 773 Aug 53

The finding of a cardiac tamponade (CT) as initial manifestation of lung cancer is rare, being its most frequent manifestations dyspnea, cough and edemas. The presence of alithiasic acute cholecystitis (AAC) as early manifestation of CT is extremely rare, despite this having being described related to other situations of low cardiac output. We present the case of a patient who underwent emergency surgery due to AAC as a form of presentation of CT, this being the initial manifestation of a pulmonary adenocarcinoma. The histopathological study of the liver and the vesicle were compatible with signs of short evolution venous stasis, and the diagnosis was established through pericardium biopsy and thoracic CAT.
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PMID:[Acute acalculous cholecystitis complicating the presentation of cardiac tamponade as the initial manifestation of a pulmonary carcinoma]. 774 16


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