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R J Piorkowski

Publications and source records attributed to R J Piorkowski.

5 recordsLinked to original sources
PubMed1991

Malignant primitive neuroectodermal tumor presenting as a scalp nodule.

We report a case of a 20-year-old woman who presented with a 3-year history of a stable cystic nodule on the scalp. Light microscopy of the excised nodule demonstrated a malignant small round cell undifferentiated neoplasm. Immunohistochemical studies suggested a neural crest origin, while ultrastructural examination revealed characteristics of schwannian differentiation. Both of these special techniques were essential in establishing the diagnosis of a malignant epithelioid schwannoma of superficial tissue (neurotropic melanoma, desmoplastic melanoma). We discuss the differential diagnoses and describe the immunohistochemical and ultrastructural characteristics of this tumor. This case illustrates the difficulty of diagnosing this rare malignant tumor, which masqueraded as a benign-appearing scalp lesion.

Adult↗
PubMed1982

Pancreatic and periampullary carcinoma. Experience with 200 patients over a 12 year period.

The operative management of 200 patients with pancreatic and periampullary cancer was reviewed. Patients with metastatic disease and biliary obstruction are best treated by the nonoperative techniques of biopsy and internal biliary drainage if technically feasible. For patients who undergo exploration and are found to be candidates for a bypass procedure, both biliary and gastroduodenal bypass should be performed. Lymph node involvement and age of the patient were found to be significant variables in determining the candidates suitable for curative resection. A definite incidence of multicentricity was found in patients undergoing total pancreatectomy for ductal carcinoma of the pancreas; however, significant problems with diabetic management arose from this procedure. The primary site of the lesion as well as the intelligence and socioeconomic background of the patient should dictate the type of resection employed. Pancreatoduodenectomy (Whipple procedure) is recommended for periampullary cancers other than pancreatic carcinoma, while total pancreatectomy may be appropriate in selected patients. However, there has been no evidence thus far in this early trial with total pancreatectomy that more complete resection of the pancreas leads to longer survival.

Ampulla of Vater↗
PubMed1981

Is aggressive surgical treatment indicated for recurrent benign mixed tumors of the parotid gland?

The surgical treatment for recurrent or incompletely excised benign mixed tumors of the parotid gland is analyzed. In this series no operative procedure proved superior to another. For each patient the type of surgical procedure used must be individually selected. For patients with tumors recently excised or biopsied, superficial parotidectomy with excision of the skin scar is the minimal recommended procedure. Radiation therapy is not used as a primary method of treatment. It is however, recommended postoperatively for patients with very advanced recurrent tumor or inadequate surgical margins.

Adenoma↗