1/126. Small cell lung cancer accompanied by lactic acidosis and syndrome of inappropriate secretion of antidiuretic hormone.Lactic acidosis is a rare complication in lung cancer. We report a case of lung cancer accompanied by both syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and lactic acidosis. A 70-year-old man was referred to our hospital for examination of a left hilar mass shadow on a chest x-ray film. Small cell lung cancer (SCLC) was demonstrated by brushing the bronchial mucosa of the left lower lobe bronchus. His laboratory data showed SIADH and lactic acidosis that were probably due to SCLC. Fluid restriction improved SIADH, and combination chemotherapy for SCLC improved the lactic acidosis although the tumor size did not change.- - - - - - - - - - ranking = 1keywords = inappropriate secretion, antidiuretic hormone, antidiuretic, secretion, hormone (Clic here for more details about this article) |
2/126. Primary advanced gastric small cell carcinoma: a case report and review of the literature.We report a 73-yr-old man with primary advanced gastric small cell carcinoma, pure type. A large, Borrman type I tumor was located from the cardia to the entire gastric fundus and upper body. Atypical cells showed a round nucleus, small nucleolus, dense to granular chromatin, and scant cytoplasm. The histological findings indicates an advanced stage and exposure to the gastric serosa. Mitotic figures were observed. There was a proliferation of a sheet-like, solid pattern, but no rosette-like, sqamoid, or glandular patterns. The neoplastic cells were positive for Leu-7 (CD57) and 123C3 (CD56, neural cell adhesion molecule, NCAM) on the surface membrane. We diagnosed this case as primary advanced gastric small cell carcinoma, pure type, and report that Leu-7 and 123C3 monoclonal antibodies are useful markers for gastric small cell carcinoma. The 32 previously reported cases of gastric small cell carcinoma are also reviewed.- - - - - - - - - - ranking = 0.008155086268635keywords = adh (Clic here for more details about this article) |
3/126. Severe muscle weakness due to hypokalemia as a manifestation of small-cell carcinoma.We describe the case of a 56-year-old man with severe muscle weakness due to heavy hypokalemia (serum potassium 1.44 mmol/l) associated with inappropriate kaliuria and alkalemia. Subsequent investigation revealed the presence of ectopic ACTH hypersecretion due to a small-cell lung carcinoma. A significant clinical/laboratory improvement was achieved following chemotherapy-induced regression of the primary tumor. The profound hypokalemia was probably the result of cortisol hypersecretion, which in concert with the ACTH-induced decreased 11beta-hydroxysteroid dehydrogenase activity can exhibit an increased mineralocorticoid activity. In addition, other ACTH-dependent mineralocorticoids may play a contributory role in the development of severe hypokalemia.- - - - - - - - - - ranking = 0.0071273168346319keywords = secretion (Clic here for more details about this article) |
4/126. Marked increase in plasma ACTH with tumor reduction after chemotherapy in ectopic ACTH syndrome.We report on a case of rapid and marked hormone release as a result of rapid tumor reduction due to chemotherapy in a 36-year-old woman with ectopic ACTH syndrome due to small cell lung cancer. Treatment of the cancer with cisplatin and etoposide resulted in an 80% reduction in tumor size on computed tomographic scan within two weeks. Concurrently, plasma ACTH exhibited an unexpected and astonishing increase from 373 pg/ml before treatment to more than 1200 pg/ml. There were no biochemical characteristics observed in tumor lysis syndrome of solid tumors such as azotemia, increased LDH and hyperkalemia. The present case indicates that anticancer chemotherapy instituted in patients with ectopic ACTH syndrome could result in an acute increase of plasma ACTH and exacerbation of hypercortisolism, similar to tumor lysis syndrome, which is a potentially fatal complication following anti-cancer chemotherapy.- - - - - - - - - - ranking = 0.00051459482801097keywords = hormone (Clic here for more details about this article) |
5/126. Syndrome of inappropriate secretion of antidiuretic hormone in malignancy.OBJECTIVES: To provide a review of pathophysiology, epidemiology, signs and symptoms, diagnosis, treatment, and nursing management of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in malignancy. DATA SOURCES: research reports, review articles, and book chapters relevant to SIADH. CONCLUSIONS: The principle cause of hyponatremia in malignancy is SIADH. Early recognition and prompt treatment can prevent serious neurologic sequelae. Antineoplastic therapy and methods to correct hyponatremia constitute effective treatment strategies. IMPLICATIONS FOR NURSING PRACTICE: nurses play a major role in nursing assessment, appropriate interventions and symptom control, and promoting resolution of problems and optimal quality of life in patients with malignancy complicated by SIADH.- - - - - - - - - - ranking = 1keywords = inappropriate secretion, antidiuretic hormone, antidiuretic, secretion, hormone (Clic here for more details about this article) |
6/126. Esophageal small cell carcinoma with ectopic production of parathyroid hormone-related protein (PTHrp), secretin, and granulocyte colony-stimulating factor (G-CSF).A patient with primary small cell carcinoma of the esophagus is reported, in whom we have studied the secretion of a variety of hormones and cytokines. The tumor was an intermediate cell type of small cell carcinoma and had either epithelial and neuroendocrinological characteristics. Furthermore, hypercalcemia and neutrophilia were present, and the tumor was shown to produce PTHrp, secretin, and G-CSF. The present case is the first report of primary small cell carcinoma of the esophagus with ectopic production of PTHrp, secretin, and G-CSF.- - - - - - - - - - ranking = 0.0061366325573708keywords = secretion, hormone (Clic here for more details about this article) |
7/126. Superficial undifferentiated small cell carcinoma of the esophagus showing an interesting growing pattern in histology.We report a case of superficial undifferentiated small cell carcinoma of the esophagus. The histology of the tumor was interesting; there was squamous cell differentiation within the epithelial layer and undifferentiated small cells growing within the submucosal layer. The tumor had a negative Grimelius reaction, suggesting no differentiation into a hormone-producing carcinoma known as an apudoma (Amine Precursor Uptake and decarboxylation (APUD)). The serum levels of ACTH and calcitonin were within normal limits. As the patient was elderly and had a history of pleural tuberculosis causing poor pulmonary function, and owing to the fulminant nature of this carcinoma, he underwent blunt dissection of the esophagus by posterior mediastinal gastric pull-up. The patient recovered quickly and was able to be discharged with a good quality of life until the tumor recurred as a liver metastasis 6 months later.- - - - - - - - - - ranking = 0.00051459482801097keywords = hormone (Clic here for more details about this article) |
8/126. Transient pituitary hypothyroidism in a patient with ectopic adrenocorticotrophic hormone secretion.We report the case of a 55-year-old woman who presented with hypercortisolism secondary to ectopic adrenocorticotrophic hormone secretion and severe non-thyroidal illness syndrome (NTIS) due to metastatic small cell lung carcinoma associated with severe infections. The patient initially showed hormonal profiles of pituitary hypothyroidism and gonadal hypofunction. After decrease in cortisol production following treatment with chemotherapy and metyrapone, serum thyroid hormones and thyroid-stimulating hormone (TSH) concentrations normalized. Study of the relative contributions of cortisol and pro-inflammatory cytokines (interleukin-6 and tumour necrosis factor alpha) to the overall variability in thyroid function tests disclosed a significant and independent effect of serum cortisol on serum TSH concentrations; the variability in free thyroid hormone concentration was explained only by changes in TSH concentration. These observations indicate that cortisol could be the major determinant of changes in serum TSH concentrations in clinical conditions accompanied by hypercortisolism, as occurs in NTIS.- - - - - - - - - - ranking = 0.021935050710668keywords = secretion, hormone (Clic here for more details about this article) |
9/126. Biphasic intra-abdominal desmoplastic small cell tumor in a patient with proximal spinal muscular atrophy.A case is reported of intra-abdominal desmoplastic small cell tumor (IDSCT) with biphasic histologic features in a patient with proximal spinal muscular atrophy. The tumor was composed of small epithelial cell nests with spindle cell sarcomatous areas. Both areas were surrounded by a desmoplastic stroma. Immunohistochemical studies revealed reactivity for low molecular weight cytokeratin, epithelial membrane antigen, vimentin, desmin and Leu-7 in both areas. Electron microscopic examination demonstrated paranuclear aggregates of intermediate filaments, zonula adherens and basement membrane-like material in the epithelial cells, while spindle cells in the tumor had fewer intracytoplasmic organelles. However, intermediate or transitional forms of both types of tumor cells were frequently observed. Although IDSCT are known to express multi-phenotypes immunohistochemically, attention should be paid to the broad spectrum of cell morphology in these tumors.- - - - - - - - - - ranking = 0.008155086268635keywords = adh (Clic here for more details about this article) |
10/126. Intra-abdominal desmoplastic small round cell tumor.BACKGROUND: Intra-abdominal desmoplastic small round cell tumor is a rare malignancy with a predilection for young males. Unique histological and immunocytochemical features distinguish the tumor from other members of the family of small round cell tumors of infancy and childhood. The aggressive nature of tumor spread, relative insensitivity to chemotherapy, and generally incomplete resectability result in a very poor prognosis. The authors report a case of a 39-year-old man with diffuse abdominal and pelvic involvement of intra-abdominal desmoplastic small round cell tumor treated with aggressive chemotherapy and surgery. methods: Computed-tomography (CT)-guided biopsy of an omental mass was performed. Histologically, discrete nests of uniform closely packed malignant cells were distributed in a background of focally desmoplastic stroma. Immunocchemistry demonstrated positivity for epithelial, mesenchymal, and neural markers. On the basis of these unique histological and immunohistochemical characteristics, the diagnosis of desmoplastic small round cell tumor was made. The patient was treated with aggressive neoadjuvant chemotherapy consisting of a high-dose alkylator -based combination regimen, followed by surgery. RESULTS: The patient had a 10 to 15 percent regression in tumor mass in response to chemotherapy. laparotomy revealed two large omental masses, another large mass adherent to the left colon and pelvic sidewall, and diaphragmatic, peritoneal and mesenteric studding with small nodules. Complete surgical resection was not possible. CONCLUSIONS: Intra-abdominal desmoplastic small round cell tumor remains an aggressive malignancy with an extremely poor prognosis. Although some response to chemotherapy may be possible, complete resection is rare, and surgical efforts are general palliative.- - - - - - - - - - ranking = 0.008155086268635keywords = adh (Clic here for more details about this article) |
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