1/818. Radicular pain can be a symptom of elevated intracranial pressure.We report two patients with leptomeningeal metastatic disease, one from breast cancer and the other from a spinal cord glioma, who developed episodic elevated intracranial pressure (ICP), each episode accompanied by the gradual onset of severe spine and radicular pain. Symptoms of pain promptly and completely resolved with opening of the on-off valve of each patient's ventriculoperitoneal shunt. It is theorized that the patients' radicular pain was caused by nerve root ischemia secondary to elevated ICP.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
2/818. Ductal carcinoma in situ recurrent on the chest wall after mastectomy.Two patients with local recurrence on the chest wall subsequent to mastectomy for ductal carcinoma in situ (DCIS) are presented. One recurrence was invasive carcinoma and the second was DCIS. Excision and chest wall irradiation, together with chemotherapy in the first patient, have provided subsequent disease-free survivals of 6 and 12 years respectively. Although mastectomy for DCIS is almost always curative, the possibility of local recurrence requires careful surveillance.- - - - - - - - - - ranking = 10.638871407172keywords = chest (Clic here for more details about this article) |
3/818. granular cell tumor of the breast: report of a case.A case of granular cell tumor of the breast in a 43-year-old woman is described. The patient presented with a painless mass in the upper-outer quadrant of her right breast. mammography showed a spiculated tumor and ultrasonography demonstrated a hypoechoic mass with an irregular border. Magnetic resonance (MR) mammography revealed a homogeneous enhanced mass in T1-weighted images using Gd-DTPA and a ringed high-intensity area around the mass in T2-weighted images. Fine-needle aspiration cytology failed to show any malignant cells. A partial resection of the breast was performed and histological examination revealed a granular cell tumor. Granular cell tumors are generally always benign, but they may be misdiagnosed as malignant tumors because of their mammographic and ultrasonographic findings. MR mammography did not reveal a typical breast cancer in either T1- or T2-weighted images in the present case. This case illustrates the need for care in preoperative examinations in order to avoid overdiagnosis of breast cancer.- - - - - - - - - - ranking = 0.30357805757148keywords = area, pain (Clic here for more details about this article) |
4/818. The dentist's role in end-of-life care.dentists and dental specialists have much to offer in ensuring proper pain management in end-of-life care for terminally ill patients. As the population of the united states ages and devastating disease processes continue to affect many, the need for oral comfort care measures will further increase. In an ideal situation, the dentist will be among those consulted in advance of beginning therapeutic regimens that have significant oral side-effects or for cases in which oral care after treatment has begun is accompanied by greatly increased risk. The objectives for dentists caring for terminally ill patients include ensuring comfort, eliminating sites of infection or potential infection, understanding the patient's preferences enhancing oral function, and, when desired, protecting self-esteem through esthetic maintenance. The provision of adequate pain management and comfort care is an unequivocal ethical obligation for the benefit of these patients. dentists have a further ethical obligation to share their knowledge with physicians and patients to set a higher standard for comfort care for the terminally ill.- - - - - - - - - - ranking = 0.28571428571429keywords = pain (Clic here for more details about this article) |
5/818. Bone agent localization in hepatic metastases.We present the bone scintigrams of two patients, which demonstrate diffuse extraosseous uptake of a bone agent in metastatic masses in the liver, one from a primary lung tumor and one from a primary breast tumor. The bone imaging agent did not localize in the brain metastases in these patients. CTs of the abdomen in both patients showed massive metastases in the liver with multiple areas of tumor necrosis. The CT of the abdomen of the breast cancer patient showed multiple small hepatic calcifications. autopsy revealed massive tumor necrosis with calcifications in the enlarged liver. In routine bone scintigraphy, diffuse uptake of bone agents in the liver of a patient with a known malignancy should be considered suggestive of massive hepatic metastases.- - - - - - - - - - ranking = 0.16072091471434keywords = area (Clic here for more details about this article) |
6/818. A leptomeningeal metastasis revealed by sciatica.Meningeal metastatic disease usually occurs as a complication of a brain tumor and is exceptionally isolated in patients with solid tumors. We report the case of a 74-year-old woman admitted for mechanical S1 sciatica refractory to drug therapy. She had been treated for breast cancer three years earlier. Physical findings were pain upon hyperextension of the lumbar spine and absence of the ankle jerks. Analysis of cerebrospinal fluid sampled during an intrathecal glucocorticoid injection showed 1 g/L of protein and 11 normal cells per mm3. Grade 3 L5-S1 spondylolisthesis was seen on plain radiographs, computed tomography scans, and magnetic resonance imaging scans. At that point, the patient developed sphincter dysfunction and motor loss in the left lower limb in the distribution of several nerve roots. Findings were normal from a myelogram and a magnetic resonance imaging study of the brain. A repeat cerebrospinal fluid analysis showed 1.1 g/L of protein and 5 cells/mm3. Because of the discrepancy between the clinical and imaging study findings, the patient was transferred to a neurology department. A third cerebrospinal fluid study showed numerous adenocarcinoma cells, and a repeat magnetic resonance imaging demonstrated a mass in the dural sac opposite L2. A program of monthly intrathecal methotrexate injections was started. A fatal meningeal relapse occurred eight months later. CONCLUSION: This case shows that a leptomeningeal metastasis can cause isolated nerve root pain, and demonstrates the diagnostic value of magnetic resonance imaging and cerebrospinal fluid cytology in patients with atypical symptoms, particularly when there is a history of malignant disease.- - - - - - - - - - ranking = 0.28571428571429keywords = pain (Clic here for more details about this article) |
7/818. Nail changes secondary to docetaxel (Taxotere).Docetaxel is a new taxoid antineoplastic drug widely used for advanced breast cancer. skin and nail toxicity are one of the more frequent nonhematologic adverse reactions. Besides dark pigmentations and Beau's lines, subungual hemorrhage, orange discoloration, acute painful paronychia, onycholysis, subungual hyperkeratosis and transverse loss of the nail plate are described. The type of nail alteration is related with the number of cycles administered and there are no efficacious preventive measures to avoid its development. Clinicians should recognize the clinical picture of these adverse nail reactions because docetaxel is used for several neoplastic disorders.- - - - - - - - - - ranking = 0.14285714285714keywords = pain (Clic here for more details about this article) |
8/818. calcium oxalate crystals (Weddellite) within the secretions of ductal carcinoma in situ--a rare phenomenon.A case is described in which calcium oxalate (Weddellite) crystals were identified in an area of ductal carcinoma in situ of the breast. Seventy other cases were examined but no evidence of Weddellite was detected. This is evidently a rare phenomenon in carcinoma in situ.- - - - - - - - - - ranking = 0.16072091471434keywords = area (Clic here for more details about this article) |
9/818. Clinics in diagnostic imaging (35). Metastases to the breasts, skin and bone.A 46-year-old woman presented with multiple skin lumps and right hip pain. Multiple nodules were palpable in the skin over the chest and abdominal wall, and in both breasts. Bilateral mammograms showed multiple solid masses, while ultrasound demonstrated multiple subcutaneous nodules. An osteolytic lesion was seen on the right hip radiograph. Excisional biopsy of a subcutaneous nodule revealed metastatic adenocarcinoma. The diagnosis of metastases to the breast is discussed, together with imaging features of other multiple breast lesions, such as fibroadenomas and cysts.- - - - - - - - - - ranking = 1.9160023773858keywords = chest, pain (Clic here for more details about this article) |
10/818. Chest wall resection for local recurrence of breast cancer. Presented at the 99th Meeting of the Royal belgium Society of obstetrics and gynecology, Brussels May 9th 1998, belgium.We present three cases of chest wall resection for locally recurrent breast cancer and a medline review of the current literature. In selected cases full thickness resection of the chest wall may be used as a salvage procedure to improve the quality of life and prolong the survival at low morbidity and mortality.- - - - - - - - - - ranking = 3.5462904690573keywords = chest (Clic here for more details about this article) |
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