Biomedical subjects

Sarah J McAleer

Publications and source records attributed to Sarah J McAleer.

3 recordsLinked to original sources

PubMed2006

Pediatric penile tumors of mesenchymal origin.

OBJECTIVES: To describe 2 cases of mesenchymal pediatric penile tumors in a 13-year-old boy and an 11-month-old infant. Mesenchymal tumors are rare in the male external genitalia. METHODS: Two patients, one aged 13 years and one 11 months, presented with painless penile masses at the penoscrotal junction. The evaluation included serial clinical examinations and ultrasonography. Both lesions were surgically excised after increasing in size. Because of malignancy, the first patient underwent wide reexcision of the tumor site. RESULTS: The pathologic findings of the first case were combined dermatofibrosarcoma protuberans, giant cell fibroblastoma, and fibrosarcoma, a malignant tumor. Immunohistochemical staining showed strong and diffuse CD34 cytoplasmic positivity in the giant cell fibroblastoma and dermatofibrosarcoma protuberans components; the dedifferentiated fibrosarcoma tumor cells were negative for this antibody. The second case was myofibroma, a benign fibroblastic tumor with a prominent myofibroblastic component that is congenital and tends to occur within the first few months after birth. Neither patient had recurrence at 16 months and 3 years of follow-up. To our knowledge, this is the first reported case of combined dermatofibrosarcoma protuberans, giant cell fibroblastoma, and fibrosarcoma of the penis and the second reported case of isolated penile myofibroma. CONCLUSIONS: Penile tumors should be included in the differential diagnosis of pediatric penile masses. Surgical resection is often curative, but patients with malignant tumors should receive careful follow-up to monitor for recurrence.

Adolescent↗

PubMed2004

Nephrolithiasis and pregnancy.

PURPOSE OF REVIEW: Urolithiasis during pregnancy is not common, however, it is a difficult condition to both diagnose and treat. There are many safety concerns that must be considered for both the mother and fetus. In this review we detail the different options available to the urologist and we highlight a treatment algorithm that we use when faced with a pregnant patient suspect of having a urinary calculus. RECENT FINDINGS: Changes in ultrasound, limited intravenous urograms and magnetic resonance imaging have improved our ability to diagnose urolithiasis in pregnancy. Additionally ureteroscopy has emerged not only as a diagnostic tool but also as a modality for definitive treatment that can safely be used during the intrapartum period. SUMMARY: When diagnosing urolithiasis in the gravid patient, the first line study should be ultrasound, using change in resistive index and transvaginal ultrasound. If these are not diagnostic, then a limited intravenous urograms should be performed. Once a diagnosis has been established, initial treatment should be conservative since 70-80% of patients will pass their stones. When intervention is necessary, the placements of an internal stent or percutaneous nephrostomy tube or ureteroscopy with definitive stone treatment are all reasonable options.

Female↗

PubMedDate not supplied

PSA outcome following radical prostatectomy for patients with localized prostate cancer stratified by prostatectomy findings and the preoperative PSA level.

PURPOSE: Algorithms have been developed to predict time to biochemical failure (BF) following radical prostatectomy (RP) for patients with clinically localized prostate cancer. The purpose of this study was to validate an algorithm based on prostatectomy findings and to evaluate whether the preoperative serum prostate specific antigen (PSA) enhances the predictive ability of the algorithm. MATERIALS AND METHODS: Between 1988 and 2002, 2417 patients underwent RP for clinically localized prostate cancer at one of 2 large university hospitals. Patients were retrospectively stratified into 4 risk groups based upon prostatectomy grade, stage, and margin status, and were then dichotomized by the preoperative PSA level (cut point 10 ng/mL). Cox regression multivariable analyses were performed to evaluate the ability of the risk group and preoperative PSA level to predict time to BF (PSA more than 0.2 ng/mL) following RP. RESULTS: The preoperative PSA level (P < 0.0001) and risk group (P < 0.0001) were significant predictors of time to BF following RP. Estimates of the BF rates 7 years following RP were 13%, 30%, 51%, and 72% for groups 1-4, respectively (pairwise P values <or=0.0002). Further stratification within each risk group using the preoperative PSA level with a cut point at 10 ng/mL revealed BF rates of 8% versus 35%, 25% versus 54%, 31% versus 73%, and 63% versus 86% for risk groups 1-4, respectively (all P values <0.0001). CONCLUSIONS: An algorithm to predict BF based on prostatectomy findings has been validated, and the addition of the preoperative PSA level improved its ability to identify high risk patients who may benefit from entry into adjuvant treatment trials.

Algorithms↗