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Biomedical subjects

R Nieberg

Publications and source records attributed to R Nieberg.

9 recordsLinked to original sources
PubMed1996

Dysgerminoma: the role of conservative surgery.

Twenty-five cases of pure ovarian dysgerminoma treated at UCLA Medical Center between 1958 and 1992 were reviewed retrospectively. Patterns of recurrence and overall survival were analyzed with regard to primary surgery (conservative versus nonconservative), use of adjuvant therapy, and stage of disease. Fourteen patients (56%) underwent conservative surgical therapy defined as preservation of the contralateral ovary, 10 patients (40%) had nonconservative primary surgery, and one patient (4%) had chemotherapy as primary treatment. Three patients (12%) received adjuvant chemotherapy and nine patients (36%) received postoperative radiation therapy. Fifteen patients (60%) had stage I disease, four (16%) stage II, and three each (12%) had stage III and IV disease. Nine patients (36%) experienced recurrence of disease. Seven of these nine patients (78%) had stage I disease and all seven had undergone conservative primary surgery with preservation of the contralateral ovary. Six of the seven had received no adjuvant therapy. Only one of these seven patients experienced recurrence in the preserved ovary. She was found to have a dysgenetic ovary and an XY karyotype. Three patients with recurrent disease had received radiation therapy after primary surgery. Twenty patients (80%) were alive without disease at follow-up, two patients (8%) were alive with disease, and three (12%) had died of disease. There was no statistically significant difference in recurrence rates between those patients treated with conservative surgery and those treated with nonconservative surgery, although the total number of patients with recurrences was greater in the former group. Our data suggest that a conservative surgical approach is the preferred treatment in patients with pure dysgerminoma of the ovary who desire future fertility. Lack of adjuvant chemotherapy or radiation therapy, rather than type of initial surgery, may be associated with a higher risk of recurrence.

Adolescent↗
PubMed1993

Primary leiomyosarcoma of the ovary in a perimenarchal female.

A case of primary leiomyosarcoma of the ovary in a perimenarchal female is presented. Previous to this report, ovarian leiomyosarcoma was thought to arise predominantly in postmenopausal women and, indeed, this is the first reported case in a pubertal adolescent. The sarcoma was associated with bilateral cellular ovarian leiomyomas, suggesting malignant degeneration of such tumors. After complete resection, the patient is alive without evidence of recurrent disease 20 months after diagnosis. A review of the literature suggests that chemoradiation is of unproven benefit and aggressive surgical management is recommended.

Cerebellar Neoplasms↗
PubMed1990

Pancreatic cystic endocrine neoplasms.

A rare case of cystic pancreatic endocrine tumor is presented, and the literature is reviewed. The patient was initially misdiagnosed as having a pancreatic pseudocyst, and that condition was managed accordingly. Persistence of the cystic lesion and reoperation led to the correct diagnosis and management. The neoplasm stained positive for glucagon and pancreatic polypeptide, but there were no clinical abnormalities that suggested hyperfunction. All cystic lesions of the pancreas should undergo biopsy at operation, to avoid an erroneous diagnosis of benign pseudocyst. Neoplastic lesions should be resected, not internally drained.

Adenoma, Islet Cell↗
PubMed1989

Uterine tumors in ataxia-telangiectasia.

Roughly one-third of patients with ataxia-telangiectasia (AT) develop malignant tumors, usually of lymphoid origin. AT patients also exhibit progeric changes. We describe three patients, between the ages of 27 and 32 years, with uterine tumors: one with a frank leiomyosarcoma and chronic T-cell leukemia, one with a multilobulated leiomyoma of uncertain malignant potential, and one with an unremarkable leiomyoma. Thus, the spectrum of tumors in AT patients beyond adolescence includes nonlymphoid malignancies and precocious, benign leiomyomas.

Adult↗
PubMed1982

Aspiration cytology is superior to Tru-Cut needle biopsy in establishing the diagnosis of clinically suspicious breast masses.

Eighty-one consecutive patients with breast masses clinically suspicious for malignancy were evaluated prospectively. There were 31 benign lesions and 50 malignancies. Clinical diagnosis was correct in 85% (2.5% false negative, 12.5% false positive). Mammography was diagnostic in 52.8% (31.5% false negative, 15.7% false positive). Needle biopsy was accurate in 78.9% (21.1% false negative, 0% false positive). Aspiration cytology was diagnostic in 96.2% (3.8% false negative, 0% false positive). Statistical comparison of all four tests revealed that aspiration cytology was slightly more accurate than physical examination for all lesions (p = 0.07), but significantly more accurate for benign lesions (p = 0.005). Overall, aspiration cytology was significantly more accurate than mammography (p = 0.000001) and needle biopsy (p = 0.008). Only one minor complication, a superficial infection, occurred with aspiration cytology and needle biopsy. Thin-needle aspiration cytology is a benign procedure that appears to be superior to physical examination, mammography, and needle biopsy in establishing the diagnosis of clinically suspicious breast masses.

Adult↗
PubMed1980

Peroperative pancreatic aspiration for evaluating pancreatic disease.

Nineteen patients who underwent peroperative pancreatic aspiration during 1976 to 1978 were retrospectively compared with 19 other consecutively chosen patients who underwent pancreatic surgery without this procedure in 1973 and 1974. In 18 of the 19 patients who had pancreatic aspiration, an accurate diagnosis was obtained. Three patients in the 1973 to 1974 series had serious postoperative complications attributable to incorrect intraoperative diagnosis and subsequent operative therapy. Peroperative pancreatic aspiration cytology provides a definitive diagnosis that may result in the most efficacious therapy for pancreatic disease.

Adult↗
PubMed1975

Hyperviscosity syndrome associated with necrotizing enterocolitis.

Hyperviscosity, or decreased fluidity secondary to increased numbers of red blood cells, leads to tissue hypoperfusion. We report the case of an infant with hyperviscosity who died from necrotizing enterocolitis (NEC), and describe the presumptive association between NCE and hyperviscosity.

Adult↗