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Biomedical subjects

S Flanigan

Publications and source records attributed to S Flanigan.

At least 19 recordsLinked to original sources
PubMed1994

Malignant acoustic schwannoma.

An unusual pleomorphic tumor was resected from the cerebellopontine angle of a 40-year-old man with no stigmata of neurofibromatosis. The tumor showed multinucleated giant cells scattered amid smaller, slightly elongated cells. The tumor showed a rudimentary fascicular pattern containing some looser areas but no nuclear palisading. A diagnosis of Schwann cell tumor was made based on ultrastructural findings and on immunoreactivity for S100 protein. Malignancy was suggested by the extreme pleomorphism of the tumor, by the presence of tripolar mitotic figures, and by flow cytometric demonstration of aneuploidy and of a significant proportion of S-phase tetraploid nuclei (9%). Ten months after the first operation, the tumor had regrown to its original size, and was again resected. The histologic and ultrastructural appearances were similar to those of the first specimen, but flow cytometric analysis now showed a double aneuploid population of nuclei and showed 12% of the nuclei in tetraploid S phase. Within 11 months of the second operation, the tumor had regrown to an estimated size of 22 cm3. Four months of radiotherapy subsequently halted tumor growth, but additional lesions appeared in the cervical and high thoracic areas.

Adult↗
PubMed1987

Giant invasive prolactinomas.

Two of the largest prolactinomas ever documented that have been followed for nine and 10 years, respectively, demonstrate how aggressive prolactinomas may become and how difficult invasive prolactinomas are to treat. One of these prolactinomas invaded both internal auditory canals and simultaneously grew inferiorly, reducing the bony support of the skull and necessitating the patient to utilize both hands to hold his head up. The second patient's prolactinoma invaded the sphenoidal, ethmoidal, and cavernous sinuses. Both of these patients had neurosurgical debulking of their tumors followed by radiation therapy. Neither patient's prolactin levels decreased significantly during their first five years post-surgically, at which time bromocriptine was added. Since then, there has been a gradual lowering of serum prolactin levels and a decrease in the size of these tumors. These cases demonstrate that prolonged treatment and very large doses of bromocriptine may be necessary for tumor reduction in patients with invasive prolactinomas.

Adult↗
PubMed1987

MR imaging of spinal epidural sepsis.

Four patients with spinal epidural sepsis were evaluated with MR imaging. The lesions were best visualized with spin-echo techniques with long repetition (2000 msec) and long echo (80-100 msec) times. Sagittal and axial images were equally important in defining the extent of the lesions. Comparison with available contrast-enhanced CT scans showed that MR was more definitive in the early demonstration of the abscesses. This early recognition influenced the management greatly and improved the clinical outcome significantly. The findings in our four cases support previous reports that MR is superior to other imaging methods for early recognition and anatomic localization of infectious diseases in patients suspected of having either spinal osteomyelitis or spinal epidural sepsis.

Adult↗
PubMed1985

Bremsstrahlung imaging after 32P treatment for residual suprasellar cyst.

A patient with residual suprasellar cystic neoplasm was treated by direct instillation of the 32P colloid. The incidental bremsstrahlung images on a conventional gamma camera helped to localize the pharmaceutical within and outside of the lesion. Advantages of bremsstrahlung imaging and the dosimetry results of phantom studies carried out are described.

Craniopharyngioma↗
PubMed1985

Intraoperative ultrasound for spinal lesions.

A variety of spinal pathological processes demonstrated by intraoperative ultrasound is presented. Use of spinal ultrasound proved helpful in viewing alignment, assessing spinal cord pathology, and viewing anterior to the cord in cases of spinal trauma. As an operative adjunct, ultrasound was especially helpful for viewing extradural spinal metastases and cavitary lesions of the spinal cord, such as syrinxes, cystic tumors, and hematomas. In cases of spondylotic myelopathy, intraoperative ultrasound allowed assessment of the adequacy of the decompression, the space ventral to the cord, and the size and configuration of the spinal cord.

Cervical Vertebrae↗
PubMed1983

Value of computed tomographic myelography in neurofibromatosis.

Computed tomographic myelography (CTM) is the procedure of choice in patients exhibiting spinal manifestations of neurofibromatosis. Due to the lack of specificity of several of the more important plain spine radiographic findings in this disease, CTM may be necessary to distinguish between surgical and nonsurgical entities. CTM will determine the size, shape, and intraspinal extension of posterior mediastinal neural tumors and separate them from the more common thoracic meningoceles. CTM will likewise elucidate the causes of posterior vertebral body scalloping, distinguishing between dural ectasia and neural tumor. CTM will also frequently demonstrate additional asymptomatic lesions at other levels.

Adult↗
PubMed1981

Arteriography after carotid endarterectomy.

Of 55 patients undergoing carotid endarterectomy, 16 had abnormal postoperative angiograms by accepted literature criteria. Five of the 16 were symptomatic. The other 11 were neurologically stable or improved from their preoperative condition. None of the 16 patients underwent reoperation. Of those 11 who had abnormal postoperative angiograms but a good clinical result, four had a second postoperative angiogram some months later that demonstrated marked improvement in the appearance of the endarterectomy site. Patients undergoing carotid endarterectomy should not be subjected to routine postoperative angiography without clinical indications nor should they undergo reoperation on the basis of angiographic findings alone without consideration of their clinical status.

Adult↗