Biomedical subjects

S C Immerman

Publications and source records attributed to S C Immerman.

4 recordsLinked to original sources

PubMed1999

Mediastinal parathyroid cysts revisited.

BACKGROUND: A case of a functioning mediastinal cyst is presented. METHODS: A comprehensive review of the literature found 93 patients in whom a parathyroid cyst or cysts extended into, or was completely contained within, the mediastinum. Including our patient, there were 46 men and 45 women, and the gender was not recorded in three. RESULTS: The cysts were located in the anterosuperior region in 56 patients, in the middle region of the mediastinum in 26, and in the anterior, prevascular region in 12. Thirty-nine patients had functioning cysts associated with hyperparathyroidism of varying severity; seven patients presented with a hypercalcemic crisis. Local symptomatology consisted of a neck mass, respiratory distress, and occasional dysphagia or chest pain. Recurrent laryngeal nerve paresis was present in nine patients, and innominate vein compression or thrombosis was present in two. The cysts in all but four patients were treated by open surgical excision; two were treated by thoracoscopy, and two patients only had fine-needle aspiration of the cyst. The cyst was excised via a cervical approach in 67 patients and by a thoracotomy or median sternotomy or a variation thereof in 23. There was no operative mortality and morbidity was minimal. CONCLUSION: Surgical resection was successful in all and remains the treatment of choice for mediastinal parathyroid cysts.

Female↗

PubMed1983

Recurrent squamous cell carcinoma of the skin.

A retrospective analysis of all patients having the diagnosis of squamous cell carcinoma of the skin at a single hospital over a ten-year period was performed. These lesions are less common than both basal cell carcinomas and malignant melanomas. Noninvasive squamous cell carcinomas were not observed to recur. There was a 20% incidence of recurrence in 86 patients with invasive squamous cell carcinoma. The presence of solar changes in the skin did not obviate recurrence. The larger, less differentiated lesions had a greater probability of recurrence. When the depth of invasion of the lesions were determined, it was found that only the lesions that penetrated to Clark's Level IV or V recurred. Squamous cell carcinomas that penetrate to this depth have the potential to recur and metastasize to regional lymph nodes and should be considered malignant lesions, even if they are associated with actinic skin changes.

Aged↗

PubMed1982

Causes and evaluation of tumor-induced hypoglycemia.

We treated four patients who had hypoglycemia and nonpancreatic tumors. Two had pleural mesothelioma, one had primary fibrosarcoma of the liver, and one had pheochromocytoma metastatic to the liver. We propose four mechanisms for this syndrome: (1) insulin or insulin-like activity produced by the tumor, (2) decreased gluconeogenesis, (3) disruption of glucagon metabolism, and (4) increased utilization of glucose by the tumor. The local effects of the tumor in hepatic parenchyma may also play an important role. The important diagnostic tests are an insulin-glucose ratio, to rule out insulinoma, and fasting glucose levels. An assay of nonsuppressible insulin-like activity can be performed and is of investigative interest, but does not aid in individual patient therapy. Treatment consists of control of the tumor.

Adrenal Gland Neoplasms↗

PubMed1981

Site of recurrence in patients with stages I and II carcinoma of the lung resected for cure.

Ninety-nine patients with Stage I or II lung carcinoma that was other than the small cell type and who survived for more than 30 days after a "curative" resection were followed for five years or until death if it occurred prior to the five-year anniversary. Recurrent disease developed in 44 patients. Clinical data and data from postmortem examination were reviewed in these 44 patients in an attempt to classify each recurrence as either initially local or distinct metastatic disease. The site of the first documented recurrence was local in 18 patients and distance metastases in 26. When the patients with recurrence were separated into TNM categories, it was apparent that in those patients without lymph nodes metastases demonstrated in the resected specimen (N0), the initial recurrence tended to be a distant metastases, whereas in those with such involvement (N1), the initial occurrence was more often local. In light of these data, selection of appropriate initial adjuvant therapeutic modalities may be different for each type of patient.

Female↗