4901 Lang Ave Ne Suite 202
Albuquerque NM 87109
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License #: 2001-214
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Assessment of the frequency of allelic imbalance in human tissue using a multiplex polymerase chain reaction system. - The Journal of molecular diagnostics : JMD
Genomic instability can generate chromosome breakage and fusion randomly throughout the genome, frequently resulting in allelic imbalance, a deviation from the normal 1:1 ratio of maternal and paternal alleles. Allelic imbalance reflects the karyotypic complexity of the cancer genome. Therefore, it is reasonable to speculate that tissues with more sites of allelic imbalance have a greater likelihood of having disruption of any of the numerous critical genes that cause a cancerous phenotype and thus may have diagnostic or prognostic significance. For this reason, it is desirable to develop a robust method to assess the frequency of allelic imbalance in any tissue. To address this need, we designed an economical and high-throughput method, based on the Applied Biosystems AmpFlSTR Identifiler multiplex polymerase chain reaction system, to evaluate allelic imbalance at 16 unlinked, microsatellite loci located throughout the genome. This method provides a quantitative comparison of the extent of allelic imbalance between samples that can be applied to a variety of frozen and archival tissues. The method does not require matched normal tissue, requires little DNA (the equivalent of approximately 150 cells) and uses commercially available reagents, instrumentation, and analysis software. Greater than 99% of tissue specimens with >or=2 unbalanced loci were cancerous.
Primary angiomyolipoma of the pancreas. - Pancreas
Angiomyolipoma (AML) is a rare tumor characterized histologically by a mixture of spindle cells, adipose tissue, epithelioid cells, and blood vessels. AML usually occurs in the kidney but can involve the liver and, rarely, other sites. We describe a 74-year-old woman without tuberous sclerosis who presented with spontaneous hemorrhage into a primary AML of the pancreas and underwent curative surgical resection. We are aware of only one previous report describing a clear cell "sugar" tumor of the pancreas, which probably represents a monotypic epithelioid variant of AML. The pancreas should be included among sites that can give rise to AML.
Surgical treatment of neuroendocrine metastases to the liver: a plea for resection to increase survival. - Journal of the American College of Surgeons
Hepatic metastases from neuroendocrine tumors have a protracted natural history and are associated with endocrinopathies. Resection is indicated for symptom control. Previous reports have suggested improvement in survival for patients undergoing debulking procedures.The records of all consecutive patients undergoing resection of hepatic metastases from neuroendocrine tumors between 1977 and 1998 were reviewed. Tumors were classified according to histology, endocrine activity, and primary location. Patients lost to followup before 1 year were excluded. Followups were based on outpatient evaluations and were updated by correspondence. The Kaplan-Meier method was used to generate survival and recurrence curves, and the log-rank test was used for comparison.A total of 170 patients fulfilled the inclusion criteria, of whom 73 were men. Mean age (+/-SD) was 57 (+/-11.5) years. Carcinoid (n = 120) and nonfunctioning islet cell tumors (n = 18) predominated; the ileum (n = 85) and the pancreas (n = 52) were the most common primary sites. Major hepatectomy (one or more lobes) was performed in 91 patients (54%). The postoperative complication rate was 14%, and two patients died (1.2%). Operation controlled symptoms in 104 of 108 patients, but the recurrence rate at 5 years was 59%. Operation decreased 5-hydroxyindoleacetic acid levels considerably, and no patient experienced carcinoid heart disease postoperatively. Recurrence rate was 84% at 5 years. Overall survival was 61% and 35% at 5 and 10 years, respectively, with no difference between carcinoid and islet cell tumors.Hepatic resection for metastatic neuroendocrine tumors is safe and achieves symptom control in most patients. Debulking extends survival, although recurrence is expected. Hepatic resection is justified by its effects on survival and quality of life.
Multilocular cystic hepatocellular carcinoma (CHCC) mimicking mucinous cystadenocarcinoma. - Hepato-gastroenterology
Hepatocellular carcinoma with cystic formation is very rare. Only 5 cases have been reported previously in the literature. We present a 55-year-old man with a symptomatic large cystic hepatic mass. Both abdominal ultrasound and computed tomography revealed a multilocular cystic mass with solid component, occupying most of the left lobe of the liver. An extended left hepatectomy was performed on the basis of a presumptive diagnosis of a cystadenocarcinoma. Pathologic and immunohistochemical evaluation however confirmed a cystic hepatocellular carcinoma without cirrhosis. The incidence and prognosis of this rare entity is unknown.
Ossifying malignant mixed epithelial and stromal tumor of the liver: a case report of a previously undescribed tumor. - Cancer
Malignant mixed tumors of the liver in adults are rare. To the authors' knowledge, twenty-four cases of primary malignant mixed hepatic tumors have been reported in the literature since the first description by Walter in 1896. Many of the previously reported cases are now considered mixed hepatoblastoma, primary hepatocellular carcinomas with focal sarcomatous metaplasia, or epithelioid hemangioendothelioma.Clinical, radiologic, histologic and immunohistochemic methods were used to characterize an unusual example of a mixed malignant tumor of the adult liver that the authors descriptively refer to as "ossifying malignant mixed epithelial and stromal tumor" of the liver.In contrast to previously reported cases, the tumor in question was morphologically distinct. It was composed of three distinct neoplastic phenotypes: malignant spindle cells, with adenocarcinomatous differentiation, and extensive osteoid formation. The tumor was treated by partial hepatectomy. The patient was alive 8 years postoperatively as of December 2001. The distinctive combination of morphologic features and prolonged survival are much different from previously reported cases of mixed malignant hepatic tumors, which were typically rapidly fatal.The authors believe that the clinical and pathologic features of this patient's tumor are sufficiently distinctive to exclude it from the well-established categories of hepatic neoplasms. Histologically, the authors suggest the descriptive name "ossifying malignant mixed epithelial and stromal tumor of the liver" as a preliminary description for this tumor until the origin and relationship to other hepatic neoplasms are further characterized.Copyright 2002 American Cancer Society. DOI 10.1002/cncr.10345
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