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Biomedical subjects

M L Goodman

Publications and source records attributed to M L Goodman.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1987

Brain abscess complicating the use of a halo orthosis.

We report a case of brain abscess complicating the use of a halo orthosis in the treatment of a cervical spine injury suffered during wrestling. Four previous brain abscesses complicating the use of halo orthoses have been reported. All cases of abscess have been associated with overlying infection at the site of pin insertion. Our case and at least one of those previously reported may have been related to tightening of the halo pins after placement. Serious spine injuries occur rarely in wrestlers and are associated with the use of illegal holds and maneuvers in which one athlete is thrown to the mat. The pathophysiology and radiographic appearance of a unilateral facet dislocation are reviewed.

Adolescent↗
PubMed1987

Laryngeal tuberculosis as manifested in the decades 1963-1983.

Laryngeal tuberculosis is usually a complication of pulmonary tuberculosis and the clinical patterns have changed in recent decades. To evaluate the changing patterns, we reviewed 15 patients seen at the Massachusetts Eye and Ear Infirmary over a 20-year period and diagnosed as having laryngeal tuberculosis. The results showed a mean age of 56 years; a male predominance by a 2:1 ratio; minimal pulmonary lesions on radiographic studies in nine patients and one normal radiograph; clinical simulation by the tuberculous lesion of laryngeal cancer; excellent response to antituberculosis therapy; and low infectivity. Laryngeal lesions and concurrent pulmonary lesions should alert the otolaryngologist to consider systemic disease processes and the most frequent granulomatous lesion of the larynx, tuberculosis.

Adult↗
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↗
PubMed1986

Aneurysmal bone cyst in early childhood.

A case is presented of a three-year-old child with an aneurysmal bone cyst at the right distal femoral metaphysis, a rare lesion in children in this age group. Treatment of the lesion which included thorough curettage and packing of the cyst cavity with crushed cortical bone is described. The literature is reviewed.

Bone Cysts↗
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↗
PubMed1984

Mixed olfactory neuroblastoma and carcinoma. A report of two cases.

Two cases of olfactory neuroblastoma mixed with other neoplastic elements are reported. One tumor contained foci of adenocarcinoma and of ganglioneuroblastoma in addition to an undifferentiated small cell component consistent with neuroblastoma; the other tumor histologically resembled small cell undifferentiated carcinoma with foci of squamous differentiation, but was shown by electron microscopy to be neuroblastoma. The histogenesis and treatment of mixed tumors of this type are discussed.

Adenocarcinoma↗
PubMed1984

Update: palmar dislocation of the trapezoid--a case report.

A case is presented of an open palmar dislocation of the trapezoid in conjunction with dorsal dislocations of the carpometacarpal joints of the index and long fingers. Open reduction and a primary limited wrist arthrodesis were performed with good results.

Adult↗