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Biomedical subjects

E H Ruffolo

Publications and source records attributed to E H Ruffolo.

At least 19 recordsLinked to original sources
PubMed1992

A comparative study of radical vulvectomy and modified radical vulvectomy for the treatment of invasive squamous cell carcinoma of the vulva.

Forty-five patients who underwent a modified radical vulvectomy for invasive squamous cell carcinoma of the vulva were compared with forty-five patients who underwent radical vulvectomy for similar lesions. Vulvar wound infection and breakdown were infrequent in both groups. Anal incontinence developed postoperatively in five of the modified radical vulvectomy patients and in none of the radical vulvectomy patients. Urinary incontinence developed postoperatively in two of the modified radical vulvectomy patients and in seven of the radical vulvectomy patients. Possible reasons for these differences are discussed. One invasive local recurrence (2.2%) developed in the modified radical vulvectomy group and two (4.4%) local recurrences developed in the radical vulvectomy group. A modified radical vulvectomy appears to be efficacious for the vulvar phase of treatment of localized invasive squamous cell carcinoma of the vulva.

Aged↗
PubMed1989

Adenocarcinoma of the endometrium and endometrioid carcinoma of the ovary associated with pregnancy.

Nine well-accepted cases of endometrial carcinoma associated with pregnancy have been reported. A 10th patient is added and the cases are briefly summarized. At the time of her definitive surgery 6 weeks postpartum, our patient was also found to have a Stage I endometrioid ovarian carcinoma. Nine of the 10 cases have been well-differentiated adenocarcinoma or adenoacanthoma and the lesions have tended to be focal with minimal or no invasion. Given the small number of patients, conclusions regarding prognosis and treatment are difficult to make. However, in younger patients with noninvasive adenocarcinoma of the endometrium, the adnexa may be spared. Endometrioid adenocarcinoma of the ovary, discovered incidentally in our patient, is associated with a concomitant adenocarcinoma of the endometrium in 5-29% of cases, but the present case in which the lesions coexisted with pregnancy appears to be the first such report in the literature.

Abortion, Induced↗
PubMed1989

Giant Brenner tumor. Case report.

A case is reported of an unusually large benign cystic Brenner tumor. Larger solid tumors have been reported, and, additionally, proliferating Brenner tumors are most often large and cystic. However, the tumor described in this presentation appears to be the largest entirely cystic Brenner tumor reported to date.

Adult↗
PubMed1988

Basal cell carcinoma of the vulva with inguinal lymph node metastases.

Basal cell carcinoma of the vulva is a rare neoplasm which is generally thought to be indolent, locally invasive, and nonmetastasizing. A case of basal cell carcinoma of the vulva with metastases to the ipsilateral inguinal lymph nodes is presented. This is the third well-documented case in the literature of vulvar basal cell carcinoma with inguinal lymph node metastases.

Aged↗
PubMed1988

Carcinoma in situ of the vulva: 24 years' experience in southwest Florida.

We retrospectively studied 125 patients treated for carcinoma in situ of the vulva from 1961 through 1984, with follow-up ranging from one to 24 years. Patients' ages ranged from 24 to 90 years, with a mean age of 53 years. Multifocal disease was more common in women under age 40. Pruritus was the most common complaint, but 60% of the patients were asymptomatic. Twenty-five patients (20%) had other associated malignancies: carcinoma in situ of the cervix in ten patients, invasive carcinoma of the cervix in six, multifocal carcinoma in situ involving vulva, vagina, and cervix in five, vaginal carcinoma in situ in two, and endometrial carcinoma in two. Sixty-five patients were treated primarily with wide excision, 45 with total vulvectomy, seven with "subtotal" vulvectomy, three with skinning vulvectomy, and three with vulvectomy and bilateral groin node dissection; two patients refused treatment. Fifteen patients had a recurrence--recurrent carcinoma in situ in ten, and invasive carcinoma of the vulva in five. Whether the patient had had total vulvectomy or a lesser procedure appeared to make no difference in the recurrence rate. Thus a well planned excision of vulvar carcinoma in situ appears to be the treatment of choice. All recurrences were in patients over age 40, so although the lesion is histopathologically identical in the younger patients, its biologic behavior seems to be more benign. Since it is possible, however, that invasive disease will ultimately develop in some of the younger patients, careful follow-up is still required.

Adult↗
PubMed1987

Role of needle biopsy in the investigation of gynecologic malignancy.

Three methods were used to investigate and evaluate patients with primary and persistent/recurrent pelvic malignancy in the gynecologic oncology services at two medical centers. The 22-gauge Chiba needle was utilized with fluoroscopic guidance to perform fine needle aspiration (FNA) of pelvic and paraaortic lymph nodes that appeared abnormal on lymphangiography (LAG). The Tru-cut needle was used to obtain tissue samples from beneath the surface epithelium of the cervix, vaginal vault and parametrium. A disposable, hand-held syringe and 20-gauge needle were used to aspirate supraclavicular and inguinal lymph nodes and cul-de-sac nodules. One hundred thirty-eight patients were evaluated, with positive results in 66 (47.8%). Surgical exploration was used to further investigate 16 negative results that did not correlate with LAG and/or clinical presentation. The sensitivity and predictive value of a negative result for the three methods was Chiba needle FNA/LAG, 62.1% and 65.6%; Tru-cut needle biopsy, 94.4% and 93.5%; and hand-held syringe and needle, 87.5% and 66.7%, respectively. All three techniques proved to be safe, uncomplicated and rapid methods of assessing gynecologic tumor spread. Positive results from these techniques can often replace surgical exploration, with a considerable savings in patient morbidity and hospitalization, and permit additional treatment to proceed without delay. Negative results still require surgical validation.

Biopsy, Needle↗
PubMed1983

Modern management of gestational trophoblastic disease.

Gestational trophoblastic disease is a disorder of pregnancy which may present in a very benign or malignant fashion. Hydatidiform mole complicates approximately 1 in 2000 pregnancies in the United States. The diagnosis may be made prior to evacuation if the signs and symptoms are kept in mind. When the patient presents with spontaneous expulsion of typical molar tissue, a complete evaluation is carried out, including physical examination, uterine curettage for histologic study, and initiation of weekly beta subunit of HCG determinations. At 8 weeks' post-evacuation, about 50% of patients continue to have detectable serum HCG levels. Of these patients, about half may develop chorioadenoma destruens (invasive mole) or choriocarcinoma and require chemotherapy (6, 16). Patient stratification in a clinical classification system based on anatomical extent of disease and certain risk factors is essential for proper management. Review of results obtained at gestational trophoblastic disease treatment centers has shown that with exception of the high-risk patient, virtually 100 per cent cure is possible with early diagnosis and appropriate treatment. Treatment of the high-risk patient with initial triple-drug chemotherapy and simultaneous irradiation of liver or brain metastases may be expected to yield a 90 per cent complete remission. If complete remission in the high-risk patient is maintained for 3 months after cessation of treatment, there appears to be a 98 per cent chance of remaining free of disease (47). The information accumulated in the 25 years since methotrexate was introduced into the treatment of gestational trophoblastic disease has made these excellent results possible. Aggressive multiagent chemotherapy, proper patient classification, radiation, surgery, and utilization of the beta subunit of HCG to monitor therapy are all pivotal in achieving these successes of modern management.

Adult↗
PubMed1983

Glandular intraepithelial neoplasia (GIN)--a unifying concept of the precursors of endometrial adenocarcinoma.

There is considerable variation and a good deal of confusion surrounding definitions and nomenclature for premalignant lesions of the endometrium. A unifying concept, based on the model of cervical intraepithelial neoplasia, is proposed to provide a uniform, practical basis for the diagnosis and management of the precursors of endometrial cancer. Lesions would be classified as glandular epithelial neoplasia (GIN) Grades, 1, 2 and 3. Illustrated examples, and comparisons with other classifications are provided.

Adenocarcinoma↗
PubMed1982

Surfactant "apoproteins" in human amniotic fluid: an enzyme-linked immunosorbent assay for the prenatal assessment of lung maturity.

We have developed an enzyme-linked immunosorbent assay for the quantitation of human lung surfactant high--molecular weight proteins and used this assay to evaluate changes in surfactant "apoprotein" content of amniotic fluid during the last trimester of pregnancy. The amount of surfactant apoprotein in human amniotic fluid increased with advancing gestational age and correlated well with other parameters of fetal lung maturity, the lecithin:sphingomyelin ratio, and the presence of phosphatidylglycerol. The findings suggest that this test, which is relatively simple to perform, may prove useful as an additional clinical parameter for assessing fetal lung maturity and predicting more accurately fetuses at risk of developing hyaline membrane disease.

Amniotic Fluid↗
PubMed1979

Squamous papilloma of the esophagus.

We have described two cases of squamous papilloma of the esophagus, one of which is an unusual case of probable malignant transformation of a benign squamous papilloma to a low-grade verrucous carcinoma.

Adult↗