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Biomedical subjects

M L Goodman

Publications and source records attributed to M L Goodman.

At least 19 recordsLinked to original sources
PubMed1992

Benign metastasizing pleomorphic adenoma of salivary gland: diagnosis of bone lesions by fine-needle aspiration biopsy.

Two cases of benign salivary gland pleomorphic adenomas metastatic to bone (benign-metastasizing pleomorphic adenomas) diagnosed by fine-needle aspiration biopsy are presented. Both primary tumors were slightly atypical cytologically but neither case demonstrated features of carcinoma. The metastatic lesions contained benign epithelial, myoepithelial, and stromal components. In both cases the clinical history was either not known by the radiologist or not communicated to the cytopathologist interpreting the case, and a primary tumor of bone was the leading clinical diagnosis. Obtaining pertinent clinical history and comparing the cytomorphology of the bone aspirate with the primary parotid tumor allowed for an accurate diagnosis in both cases. The differential diagnosis with primary bone tumors is discussed and the importance of clinical history is emphasized.

Adenoma, Pleomorphic↗
PubMed1992

Chondroblastoma of the temporal bone. Case report and literature review.

Chondroblastoma is a rare tumor of bone that represents approximately 1% of all primary bone tumors. In the temporal bone, only 33 have been reported. We present a case of chondroblastoma of the temporal bone, followed by a literature review and analysis of reported cases. We conclude that the best chance for a prolonged disease-free interval is total excision using a combined otolaryngologic and neurosurgical approach.

Adolescent↗
PubMed1991

Solitary fibrous tumor of the nasal cavity and paranasal sinuses.

We report two solitary fibrous tumors of the nasal cavity and paranasal sinuses that were histologically and immunohistochemically virtually identical to solitary fibrous tumors (fibrous mesotheliomas) of the pleura. One tumor arose in a 48-year-old woman and the other in a 45-year-old woman. Both patients presented with nasal symptoms, and both patients are alive without evidence of disease 6 months and 1 year after excision. The tumors had a disorganized or "patternless" arrangement of spindle cells in a collagenous background and prominent vascular channels of varying size. Immunoperoxidase stains on paraffin sections showed staining of the cells for vimentin only; there was no staining for keratin, S-100 protein, desmin, and actin. Both cases presented some degree of diagnostic difficulty and had to be distinguished from other spindle cell tumors of the nasal cavity and paranasal sinuses, such as hemangiopericytoma, angiofibroma, and fibrous histiocytoma.

Biopsy↗
PubMed1990

Gamma knife radiosurgery: current status and review.

"Radiosurgery" is stereotactic neurosurgery in which the usual rigid needles or probes are replaced with beams of ionizing radiation directed toward an intracranial target so as to achieve local tissue destruction. No skin incision or skull opening is required. Lars Leksell originally defined the concept and over a prolonged research and development period created the "Gamma Knife." The Gamma Knife is a self-contained unit with 201 cobalt 60 sources arranged in a hemispheric array such that the emitted beams of radiation reach a common point of intersection. Interchangeable collimating devices allow variation of the diameter of the 50% isodose distribution from 5.0 to 24.2 mm. Larger radiation dose distributions can be achieved by multiple overlapping exposures. Initial radiation dose rate is between 300 and 400 cGy/min. Obliteration of arteriovenous malformations has been shown angiographically in 80% to 86% of optimally treated patients two years later. Growth arrest or actual decrease in tumor size has occurred in 86% of acoustic neuromas treated. Other lesions treated with the Gamma Knife have included pituitary adenomas, craniopharyngiomas, pineal region tumors, and ocular melanomas, as well as functional disorders.

Brain Diseases↗
PubMed1990

Carcinoid tumors of the middle ear.

Carcinoid tumors of the middle ear are rare lesions that represent a class within the spectrum of adenomatous neoplasms. We present four cases that were diagnosed and treated at our institution since 1973, and review the pool of 12 cases in regard to their presentation, symptomatology, physical examination, audiometric and radiographic evaluations, operative procedure and findings, histopathology, and postoperative course. Successful treatment of these low-grade malignancies requires complete excision of the tumor mass, along with the ossicles if they are involved with disease, in order to prevent local recurrence. Although locally invasive, these tumors have a low propensity for distant metastasis. The diagnosis of carcinoid tumor should be considered in all cases of adenomatous neoplasms of the middle ear and mastoid.

Adenocarcinoma↗
PubMed1990

Sinonasal hemangiopericytoma. A reassessment with electron microscopy, immunohistochemistry, and long-term follow-up.

Sinonasal hemangiopericytomas are rare, occasionally misdiagnosed neoplasms that have often been considered distinct from hemangiopericytomas of other sites. Eleven cases were studied. Nine arose from the nasal cavity and two from the paranasal sinuses. The patients' mean age was 58 years. In nine cases there were no appreciable mitoses; in two, mitoses were frequent. Of 10 cases studied by immunostaining, all were positive for vimentin; two had faint focal staining for actin; one focally expressed S-100 protein; all were negative for cytokeratins, desmin, and Factor VIII-related antigen; and none bound Ulex europaeus agglutinin 1. Five cases were studied by electron microscopy. The most consistent features were basal lamina-like material partly surrounding tumor cells and completely separating them from endothelium, tapered cytoplasmic extensions, and orderly bundles of filaments. Intercellular junctions and pinocytotic vesicles were present in some tumors. Of nine cases with adequate follow-up, tumors recurred in four cases (44%) after a mean of 6.5 years, and none metastasized. A review of the literature showed that high local recurrence rates, late recurrences, and low rates of metastasis were features of tumors in this location. This might be a reflection of early presentation, small tumor bulk, and difficulty of complete resection, rather than evidence for a biologically distinct neoplasm.

Adult↗
PubMed1989

Pathologic correlation of the unknown solid parotid mass in children.

A parotid mass in a pediatric patient is stated to have an approximately 50% likelihood of being malignant. To evaluate our experience in light of this suggested incidence, we conducted a retrospective study, which included 22 patients treated over an 8-year period, 1979 to 1987. Patients' ages ranged from 16 months to 19 years, and all patients presented with an unknown, solid parotid mass. One patient had a malignancy, mucoepidermoid carcinoma. Eight patients were diagnosed with benign pleomorphic adenoma. Thirteen patients had an inflammatory process consisting of one of the following conditions: cat-scratch disease (4); atypical mycobacteria (4); benign follicular hyperplasia of a lymph node (4); and toxoplasmosis (1). The histologic findings in this series suggest that unknown solid parotid masses that occur in children or adolescents are frequently the result of inflammatory conditions and are not likely to be malignant. We therefore recommend a reconsideration of the reputed estimation of malignancy in the parotid gland in children. The majority of pathologic conditions discovered, however, are still best diagnosed and treated by surgical excision.

Adenoma↗
PubMed1989

Stereotactic drainage of Aspergillus brain abscess with long-term survival: case report and review.

Aspergillus species are second only to Cryptococcus neoformans as the most common cause of fungal infections of the central nervous system in immunocompromised patients. Survival following treatment of Aspergillus brain abscess has been reported only 4 times. In each case, craniotomy was performed for abscess drainage. We present a case of long-term survival following stereotactic drainage of a bilateral Aspergillus brain abscess. In all reported cases, including the present one, histological examination of the abscess contents established the correct diagnosis. Amphotericin B was used in combination with operation in 4 of the 5 cases of long-term survival.

Adult↗
PubMed1989

Endocrine function in patients with large pituitary tumors treated with operative decompression and radiation therapy.

Large pituitary tumors are still a common problem. Thirty consecutive patients underwent operative decompression and radiation therapy for large sellar and suprasellar tumors. They were studied prospectively in terms of their endocrine outcome. Ten of the patients had panhypopituitarism both before and after treatment. The other 20 patients had partial hormonal deficits prior to treatment. Ten (50%) of the 20 patients who had partial preoperative deficits went on to develop delayed onset of worsening in their endocrine function; 9 of the 10 developed panhypopituitarism, and 1 patient developed decreased thyroid function. The mean time from surgery until the onset of delayed worsening in endocrine function was 26.1 months. The mean age of those patients who developed delayed onset of worsening in pituitary function was significantly higher than that of those who did not develop further hormonal loss (40.5 +/- 3.1 years versus 52.0 +/- 4.1 years, P less than 0.05). None of the 10 patients with delayed onset of worsening in pituitary function had anatomical evidence by computed tomographic scan of tumor recurrence. Delayed onset radiation effect is the most likely cause of the late onset of worsening in endocrine function.

Combined Modality Therapy↗
PubMed1988

Spinal cord injury in I-cell disease.

I-cell disease (ICD), mucolipidosis II, is an autosomal recessive syndrome resulting from defective phosphorylation of acid hydrolases. The diagnosis is made in early childhood and in most cases death occurs by age 5 as a result of cardiorespiratory complications. Pathologic changes are limited to mesenchymal tissues. We treated two children with ICD who developed atlantoaxial dislocation and myelopathy following minor injuries. The first child developed cardiovascular instability with manipulation of the C1 ring at operation, necessitating removal of the arch of C1 and fusion from occiput to C2. The second child was quadriplegic following anatomic reduction of the C1-C2 dislocation at operation during which somatosensory evoked potentials (SSEPs) showed no deleterious change. The atlantoaxial joint is unstable in ICD due to an incompetent transverse ligament infiltrated by storage cells. A cartilaginous, rather than calcified, odontoid process may contribute to the instability. The intraoperative neural injury occurred during attempts to effect anatomical reduction of the chronically dislocated C1-C2 joints and could have resulted from inadvertent trauma to the vertebral arteries and subsequent infarction of the cord. The lack of change in the intraoperative SSEPs was probably due to relative sparing of the posterior columns during the cord injury. We recommend that children with ICD and atlantoaxial instability undergo closed reduction of any existing malalignment followed by posterior C1-C2 fusion as long as the operative risk is not prohibitive. If preoperative closed reduction is not readily feasible and the cord is severely compromised, the C1 arch should be removed and the occiput fused to C2. Forceful attempts at anatomical reduction of the chronically dislocated C1-C2 segments should be avoided.

Child↗
PubMed1988

Association of an epidermoid tumor with an aneurysm of the anterior communicating artery.

A case of epidermoid tumor enveloping an aneurysm of the anterior communicating artery is reported. Four embryologically similar epithelial tumors of the central nervous system associated with intracranial aneurysms, all craniopharyngiomas, have previously been reported. Theories attempting to relate tumor and aneurysm are discussed. The incidence of aneurysm associated with tumor is difficult to estimate and may be no greater than the probability of their coincidence by chance alone.

Brain Neoplasms↗
PubMed1986

Chondrosarcoma of the temporal bone. Diagnosis and treatment of 13 cases and review of the literature.

Chondrosarcoma of the temporal bone is a rare lesion. Clinically it has been confused with multiple sclerosis, glomus jugulare tumors, meningioma, and chordomas. The cranial nerve palsies frequently observed with the tumors are related to the anatomic locations of the tumors. Thirteen patients with this entity are presented and the eleven other cases in the literature are reviewed. Histologically the tumors are low grade and exhibit myxoid features. The myxoid features must be differentiated from chordoma and chondroid chordoma. The tumor locations preclude surgical excision and conventional radiation therapy can cause unacceptable neurologic sequelae. Proton beam therapy has been effective in short-term results and appears capable of avoiding serious neurologic side effects.

Adolescent↗
PubMed1985

Symptomatic solitary granular cell tumor of the trachea.

The granular cell tumor is a neoplasm that has generated considerable controversy. A rare case of solitary granular cell tumor located in the cervical trachea is described with a new mode of therapy using the carbon dioxide laser.

Adult↗
PubMed1985

Immunohistochemical localization of keratin in head and neck neoplasms and normal tissues.

Immunohistochemical localization of keratin antigens using keratin antisera and the immunoperoxidase technique have been shown to be helpful in identifying certain epithelial cells. Our study was designed to evaluate the application of this technique to head and neck neoplasms and normal tissues using two keratin antibody preparations. Our data indicate that the keratin antibodies stained normal epithelial structures in the head and neck except for cells with active secretory functions such as mucus, cerumen, or salivary secretion. Neoplasms of the head and neck showed keratin antibody staining for epithelial neoplasms and negative staining for mesenchymal neoplasms. The immunohistologic demonstration of keratin is useful in distinguishing undifferentiated or poorly differentiated epithelial malignancies from sarcomas or lymphomas and demonstrating myo-epithelial cells in salivary neoplasms.

Animals↗
PubMed1979

The inflammatory response to endotoxin.

A typical inflammatory response resulted from the intravenous injection of endotoxin (E. coli) into living rabbits. Each rabbit was studied at three levels: the microvasculature and supporting tissue in the ear chamber was observed microscopically (up to X200) before, during, and at regular intervals following the injection of endotoxin; leucocyte and platelet counts were made periodically throughout each experiment; and tissue samples for histological study were obtained from each rabbit prior to death. The animal was anaesthetised before histological samples were secured. Within minutes after the intravenous injection of endotoxin, leucocytes were observed sticking to the endothelial cells lining the venules and the arterioles. Emboli appeared in the microcirculation within 10 min. Swelling of the microvascular endothelial cells was evident at 1 hr; oedema and extravasation of the cellular elements followed. The rectal temperature and leucocyte and platelet counts all fell within 10 min. of endotoxin. Histological examination of tissue from the ear chamber and visceral organs showed inflammatory changes. Congestion of the microvasculature, swelling of the endothelial cells, and margination and migration of neutrophils were common histological features in all organs. The earliest cells affected appeared to be the leukocyte and platelet.

Animals↗