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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Rhabdomyosarcoma of the heart is a rare tumor, especially in childhood and particularly in the left ventricle. A primary tumor of this type was successfully resected after echocardiographic assessment alone in a young girl exposed prenatally to diphenylhydantoin. The patient is well and free of recurrence 2 1/2 years later.
J Thorac Cardiovasc Surg 1987 Mar
PMID:Primary left ventricular rhabdomyosarcoma in a child: noninvasive assessment and successful resection of a rare tumor. 382 Nov 53

One hundred consecutive patients with chest wall tumors undergoing resection during the past 8 years were reviewed. There were 55 female and 45 male patients with ages ranging from 12 to 84 years (median 54.5 years). Fifty patients had primary malignant neoplasms, 32 had metastases, and 18 had benign tumors. The tumor was located in the ribs in 78 patients and in the sternum in 22. The number of ribs resected ranged from one to eight (median 3.4). Sternectomy was performed in 22 patients. Overlying soft tissue was resected en bloc in 47 patients. Reconstruction was with prosthetic material in 57 patients and autogenous ribs in 11. There were 100 muscle transpositions, including 45 pectoralis major, 33 latissimus dorsi, and 9 serratus anterior. Hospitalization ranged from 4 to 80 days (median 9.6 days). Complications occurred in nine patients. One patient required tracheostomy. There was one operative death. Median follow-up was 31.5 months. Recurrent tumor developed in seven patients. All patients with benign tumor and 95% of patients with primary tumor not previously treated were alive. However, only 41% of patients with metastatic tumor were alive. Metastases were responsible for 89% of late deaths. We conclude that aggressive resection for chest wall tumor with reliable reconstruction can be accomplished safely and that early wide resection is potentially curative treatment.
J Thorac Cardiovasc Surg 1985 Sep
PMID:Chest wall tumors. Experience with 100 consecutive patients. 403 74

From 1963 to 1983, 44 patients presented with a primary tracheal neoplasm that was amenable to surgical treatment. Forty-two of the 44 tumors were malignant. Thirty-three patients were managed by resection and primary anastomosis. The following resections were done: trachea only, 12; trachea plus carina, 13; trachea plus cricoid cartilage, four; and trachea plus larynx, four. There were two operative deaths in these 33 patients. Prosthetic reconstruction with heavy-duty Marlex mesh was done in six patients. Three of the six died of erosion of the innominate artery during the postoperative period. In three patients with nonresectable tumors, a silicone-coated Montgomery T-tube provided transient but worthwhile palliation. In two patients with nonobstructive adenoid cystic carcinoma involving the subglottis, irradiation was chosen as the initial treatment, since resection would necessitate laryngectomy. Resection, including laryngectomy, may be required in the future. The following points are emphasized: (1) A majority of operable neoplasms can be resected through a cervical collar incision and median sternotomy. Median sternotomy is the optimal operative exposure in most neoplasms necessitating resection of the carina. (2) Partial resection of the cricoid with sparing of the recurrent laryngeal nerves and larynx is possible in some patients with primary malignant tumors involving the proximal trachea and subglottic region. (3) In patients with adenoid cystic carcinoma, resection may afford excellent, long-term palliation even when the resection is incomplete. Pulmonary metastases are common in patients with adenoid cystic tumors. However, they usually progress slowly, may remain asymptomatic for many years, and are not necessarily a contraindication to resection of the primary tumor even when they are synchronous. Our experience suggests that adjunctive radiotherapy is beneficial in patients with adenoid cystic carcinoma.
J Thorac Cardiovasc Surg 1984 Oct
PMID:Experience with primary neoplasms of the trachea and carina. 609 Aug 18

Thirty-four patients with an aortic window lesion were carefully staged with gallium scans and mediastinoscopy according to the TNM classification system for carcinoma of the lung. All were in Stage III. Twenty-five patients had non-oat cell carcinomas (15 squamous cell, eight adeno-, two large cell) and nine had oat cell carcinomas. Quantitative ventilation-perfusion lung scans were particularly helpful in verifying the subaortic location of the tumor by showing a less than 20% interference with pulmonary blood flow or ventilation secondary to left mainstem bronchus or pulmonary artery invasion. Decision for resectability in 13 Stage III M0 patients was based on the length of the uninvolved proximal left main pulmonary artery seen on pulmonary arteriogram. Eight patients (seven non-oat cell and one oat cell) had resection after radiation and prior to chemotherapy (after two cycles of chemotherapy and prior to radiation therapy for the oat cell) with a resultant survival rate better than those of M0 and M1 non-oat cell or oat cell patients without resection. The survival rates of nine non-oat cell M0 patients, nine non-oat cell M1 patients, and eight oat cell patients, all without resection, were not statistically different. This similarity in survival rates is explained by the observation that 38% of the non-oat cell M1, 71% of the non-oat cell M0, and 63% of the oat cell patients died from complications of their primary tumor. Patients with aortic window lesions, irrespective of their histology, have an extremely poor prognosis due to the high incidence of lethal complications of their primary tumor. Complete resection when feasible, as judged by pulmonary arteriography, provides the best control of the primary tumor and, as a consequence, gives longer survival.
J Thorac Cardiovasc Surg 1982 Apr
PMID:Bronchogenic carcinoma located in the aortic window. The importance of the primary lesion as a determinant of survival. 627 31

Four patients with metastatic glucagonoma are described. Angiography demonstrated a small avascular primary tumor of the tail of the pancreas in one patient and large hypervascular tumors of the pancreatic head in the other three. Liver metastases, were hypervascular in all four. Including our 4 with 21 cases from the literature, glucagonomas show a 92% incidence of increased tumor vascularity--thus increasing the likelihood of successful angiographic diagnosis. The awareness of clinically subtle or atypical glucagonomas and use of plasma glucagon determination are important factors leading to early diagnosis of these neoplasms. Since angiography can localize the tumor, assess its extent, and detect hepatic metastases, it is essential to the detailed evaluation of glucagonomas.
Cardiovasc Intervent Radiol 1982
PMID:Glucagonoma and its angiographic diagnosis. 630 75

Eight middle mediastinal pheochromocytomas were located by means of 131I- meta- iodobenzylguanidine scintigraphy. The exact anatomic location of the lesions was confirmed by means of dynamic computed tomographic scanning following bolus injection of contrast medium. In all but one case the lesion had not been detected prior to scintigraphy despite extensive investigations including arteriography, venography with sampling, computed tomography with infusion of contrast medium, and in some cases surgical exploration of the abdomen and chest. Accurate anatomic location of the lesion permitted resection of five lesions from the cardiac atria and one from the aortopulmonary window. A sixth case in which an atrial pheochromocytoma was found by coronary angiography was not cured by resection of the primary tumor, and 131I- meta- iodobenzylguanidine scintigraphy revealed extensive metastases. Thus 131I- meta- iodobenzylguanidine scintigraphy has been of considerable value in the location of pheochromocytomas of the middle mediastinum, which may be a more frequent site than previously recognized.
J Thorac Cardiovasc Surg 1984 Jun
PMID:The location of middle mediastinal pheochromocytomas. 672 3

Spirometry and regional pulmonary function studies using xenon 133 gas were performed in 251 patients who had primary lung cancer. Surgical resection was undertaken in 150 while the remainder were treated with nonsurgical modalities. Pulmonary function studies were repeated postoperatively in 54 patients. Regional ventilation and perfusion of the tumor-bearing lung were decreased in patients with larger primary tumors and in those with involvement of ipsilateral hilar lymph nodes. Reduced regional function was also directly related to the proximity of the primary tumor to the hilum. Significant hypoperfusion did not contraindicate operation in 14 patients; however, 13 of them required pneumonectomy. Estimated postoperative forced expiratory volume in 1 second (FEV1.0), derived from preoperative spirometry and regional function of the tumor-bearing lung, correlated well with the measured postoperative values. These estimations were valuable in determining the extent of safe resection and correlated well with short-term survival. Long-term survival correlated better with the stage of disease.
J Thorac Cardiovasc Surg 1983 Jul
PMID:Regional and overall pulmonary function changes in lung cancer. Correlations with tumor stage, extent of pulmonary resection, and patient survival. 686 54

We reviewed the role pulmonary resection for metastatic pulmonary lesions in our institution. Over a 22 year period, 142 patients underwent 153 thoracotomies. The operative mortality was 0.7%. Complete follow-up was obtained on 140 hospital survivors (99.3%). The actuarial 5 year survival rate for carcinoma was 24% (70% confidence limit 0% to 52%) and for sarcoma was 29% (70% confidence limit 0% to 61%). The survival rate to the end of the follow-up for patients with short disease-free intervals (less than 3 months) was 30%; with free intervals of 3 to 30 months, the survival rate was 27%; with long intervals (greater than 30 months), it was 24% (p = 0.8). Six of 29 lobectomy or pneumonectomy specimens has secondary metastases in the regional nodes, but actuarial 5 year survival rates following lobectomy, pneumonectomy, or segmental or wedge excision were not statistically different. Long-term follow-up revealed an overall survival rate of 26%, which was not influenced by tumor histology, disease-free interval, or extent of pulmonary excision. In view of these findings, we continue to advocate conservative excision of pulmonary metastases when the primary tumor is controlled and other organ systems are not involved, regardless of the tumor histology or the disease-free interval.
J Thorac Cardiovasc Surg 1982 Jan
PMID:Results of pulmonary resection for metastatic lesions. 705 15

Current procedures to determine the clinical staging of disease in patients with lung cancer are lacking in accuracy, particularly regarding the presence of metastatic disease. We have evaluated the use of computed tomography (CT) of the chest, brain, and upper abdomen for clinical staging of the extent of disease in 113 consecutive patients with histologically confirmed carcinoma of the lung. Comparisons with mediastinoscopy and surgical findings were made regarding the extent of primary tumor in 47 patients and nodal involvement in 41 patients. The CT scan showed a sensitivity of 86.9%, a specificity of 91.6%, and an accuracy of 89.3% for extrapulmonary extension of the primary tumor and a sensitivity of 50%, a specificity of 96.5% and an accuracy of 82.9% for mediastinal node involvement. Thirty-two of the 85 patients studied by total body CT scan had distant metastasis, of which 24 (75%) were clinically silent. Thus 28.2% of the 85 patients studied had asymptomatic metastatic disease. We conclude that CT of the chest, brain, and upper abdomen is a reliable procedure for staging lung cancer.
J Thorac Cardiovasc Surg 1982 Oct
PMID:TNM staging in lung cancer: role of computed tomography. 712 Oct 45

Completion pneumonectomy has been associated with higher rates of morbidity and mortality and this is reflected in the selection of cases and the indications for the procedure. During a period of 14 years from January 1980 to November 1993, 38 completion pneumonectomies were done by our surgical team, representing 5.1% of all pneumonectomies. There were 24 right and 14 left completion pneumonectomies done in 26 male and 12 female patients with an average age of 61 years (range from 29 to 77 years). Lung malignancy accounted for 26 of these cases in which the indication included local recurrence in 10, second primary tumor in 9, malignancy that developed after resection for benign disease in 2, and pulmonary metastasectomy in 5 cases. Benign diseases were the indication in 12 cases: tuberculosis in 4, bronchiectasis in 4, aspergillosis in 1, and postoperative complications in 3. Additional surgical procedures were necessary in 7 cases: chest wall resection with insertion of prosthesis in 3, thoracoplasty in 2, and omental flap in 2. There was 1 early postoperative death after 5 weeks from adult respiratory distress syndrome. There was no occurrence of bronchopleural fistula, and the 18% associated morbidity rate was a result of bleeding necessitating reexploration in 3 cases, prolonged ventilation in 2, and chronic empyema in 2. Six of these complications (86%) occurred in the group with benign disease. Completion pneumonectomy can be done with an acceptable morbidity in selected patients. Careful technique is important to secure hemostasis and to avoid fistulas. The complication rate is higher when infective disease is involved.
J Thorac Cardiovasc Surg 1995 Oct
PMID:Completion pneumonectomy: indications and outcome. 747 41


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