Publications by authors named "Marc H Schiffman"

11 Publications

  • Page 1 of 1

Combination uterine artery embolization and hysteroscopic resection for a symptomatic uterine leiomyoma: A collaborative single-session approach for better patient care.

Clin Imaging 2021 Jan 30;77:111-116. Epub 2021 Jan 30.

The Department of Radiology, Division of Interventional Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA.

Uterine artery embolization (UAE) for symptomatic uterine fibroids is accompanied by transcervical fibroid expulsion in 3-15% of cases. It can be a source of significant patient distress, may require reintervention for removal, and is the most common reason for hospital readmission following UAE. Conversely, the success of hysteroscopic resection decreases with increasing fibroid size while the risk of complications increases. Because certain fibroid features identifiable on preoperative imaging predict need for eventual hysteroscopic resection, it is possible to prospectively identify such patients and employ an alternative management strategy. We present such an approach, illustrated in the case of a woman with a pedunculated broad-based uterine fibroid successfully managed via combination UAE and immediate hysteroscopic resection.
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http://dx.doi.org/10.1016/j.clinimag.2021.01.031DOI Listing
January 2021

Incidental sonographic detection of bladder cancer in a woman with large uterine fibroids: significance and lessons learned.

Clin Imaging 2020 May 7;61:1-3. Epub 2020 Jan 7.

Division of Interventional Radiology, Department of Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY 10065, United States of America. Electronic address:

Uterine leiomyomas are the most common solid pelvic tumors in pre-menopausal women and typically present with abnormal uterine bleeding and/or symptoms of mass effect. A potential consequence of the space-occupying nature of these lesions is the decreased sensitivity for the detection of adjacent pelvic pathology, which can be particularly problematic given the overlap in symptoms between fibroids and other pelvic disease. We present the case of a woman with a large uterine fibroid who had multiple imaging evaluations before undergoing uterine fibroid embolization and on immediate follow-up sonography was discovered to have early-stage bladder cancer.
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http://dx.doi.org/10.1016/j.clinimag.2020.01.001DOI Listing
May 2020

Integrative Molecular Analysis of Patients With Advanced and Metastatic Cancer.

JCO Precis Oncol 2019 20;3. Epub 2019 Sep 20.

Weill Cornell Medicine, New York, NY.

Purpose: We developed a precision medicine program for patients with advanced cancer using integrative whole-exome sequencing and transcriptome analysis.

Patients And Methods: Five hundred fifteen patients with locally advanced/metastatic solid tumors were prospectively enrolled, and paired tumor/normal sequencing was performed. Seven hundred fifty-nine tumors from 515 patients were evaluated.

Results: Most frequent tumor types were prostate (19.4%), brain (16.5%), bladder (15.4%), and kidney cancer (9.2%). Most frequently altered genes were (33%), (11%), (10%), (8%), (8%), and (8%). Pathogenic germline alterations were present in 10.7% of patients, most frequently (1.9%), (1.5%), (1.5%), and (1.4%). Novel gene fusions were identified, including a fusion in a metastatic prostate cancer sample. The rate of clinically relevant alterations was 39% by whole-exome sequencing, which was improved by 16% by adding RNA sequencing. In patients with more than one sequenced tumor sample (n = 146), 84.62% of actionable mutations were concordant.

Conclusion: Integrative analysis may uncover informative alterations for an advanced pan-cancer patient population. These alterations are consistent in spatially and temporally heterogeneous samples.
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http://dx.doi.org/10.1200/PO.19.00047DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778956PMC
September 2019

Inferior Mesenteric Arterial Supply to a Symptomatic Uterine Myoma.

J Minim Invasive Gynecol 2020 02 9;27(2):248-249. Epub 2019 Jul 9.

Division of Interventional Radiology, Department of Radiology (Drs Cornman-Homonoff and Schiffman).

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http://dx.doi.org/10.1016/j.jmig.2019.07.003DOI Listing
February 2020

Percutaneous drainage of an infected endometrioma.

Clin Imaging 2019 Nov - Dec;58:105-107. Epub 2019 Jun 22.

The Department of Radiology, Division of Interventional Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA.

Endometrioma superinfection is uncommon and poorly described in the literature. This rarity has precluded agreement on optimal management, with most authors treating these lesions as endometriomas rather than abscesses and thus recommending laparoscopic or open cystectomy or oophorectomy. We present a minimally-invasive alternative, illustrated in the case of an infected endometrioma which was successfully managed via image-guided percutaneous drainage.
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http://dx.doi.org/10.1016/j.clinimag.2019.06.012DOI Listing
March 2020

Management of Recurrent Sigmoid Volvulus via Nontransmural Percutaneous Colon Fixation.

J Vasc Interv Radiol 2019 Oct 17;30(10):1669-1671. Epub 2019 May 17.

Division of Interventional Radiology, New York-Presbyterian Hospital-Weill Cornell Medical Center, 525 East 68th Street, Box 141 New York, NY 10065.

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http://dx.doi.org/10.1016/j.jvir.2019.01.028DOI Listing
October 2019

Percutaneous Orthotopic IVC Construction in a Pediatric Patient with Symptomatic IVC Agenesis.

Cardiovasc Intervent Radiol 2019 Feb 12;42(2):308-312. Epub 2018 Nov 12.

Division of Interventional Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, 525 East 68th Street, Box 141, New York, NY, 10065, USA.

Inferior vena cava agenesis is an uncommon condition usually attributed to embryologic dysgenesis. When symptomatic, unprovoked deep venous thrombosis and/or lower extremity venous congestion are the most frequent manifestations. Its rarity has precluded consensus regarding appropriate management. Symptomatic chronic venous congestion requires surgical construction of auxiliary venous pathways, which may involve substantial morbidity, prolonged recovery and extensive scarring. We report successful minimally invasive management via percutaneous endovascular orthotopic inferior vena cava construction in a pediatric patient, thereby obviating the need for surgery and its associated morbidity. LEVEL OF EVIDENCE: Level IV, case study.
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http://dx.doi.org/10.1007/s00270-018-2098-6DOI Listing
February 2019

Bone biopsy protocol for advanced prostate cancer in the era of precision medicine.

Cancer 2018 03 19;124(5):1008-1015. Epub 2017 Dec 19.

Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York.

Background: Metastatic biopsies are increasingly being performed in patients with advanced prostate cancer to search for actionable targets and/or to identify emerging resistance mechanisms. Due to a predominance of bone metastases and their sclerotic nature, obtaining sufficient tissue for clinical and genomic studies is challenging.

Methods: Patients with prostate cancer bone metastases were enrolled between February 2013 and March 2017 on an institutional review board-approved protocol for prospective image-guided bone biopsy. Bone biopsies and blood clots were collected fresh. Compact bone was subjected to formalin with a decalcifying agent for diagnosis; bone marrow and blood clots were frozen in optimum cutting temperature formulation for next-generation sequencing. Frozen slides were cut from optimum cutting temperature cryomolds and evaluated for tumor histology and purity. Tissue was macrodissected for DNA and RNA extraction, and whole-exome sequencing and RNA sequencing were performed.

Results: Seventy bone biopsies from 64 patients were performed. Diagnostic material confirming prostate cancer was successful in 60 of 70 cases (85.7%). The median DNA/RNA yield was 25.5 ng/μL and 16.2 ng/μL, respectively. Whole-exome sequencing was performed successfully in 49 of 60 cases (81.7%), with additional RNA sequencing performed in 20 of 60 cases (33.3%). Recurrent alterations were as expected, including those involving the AR, PTEN, TP53, BRCA2, and SPOP genes.

Conclusions: This prostate cancer bone biopsy protocol ensures a valuable source for high-quality DNA and RNA for tumor sequencing and may be used to detect actionable alterations and resistance mechanisms in patients with bone metastases. Cancer 2018;124:1008-15. © 2017 American Cancer Society.
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http://dx.doi.org/10.1002/cncr.31173DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821525PMC
March 2018

Transarterial Embolization of a Bartholin Cyst before Resection.

J Minim Invasive Gynecol 2018 Sep - Oct;25(6):938-940. Epub 2017 Nov 28.

Department of Radiology, Division of Interventional Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York.

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http://dx.doi.org/10.1016/j.jmig.2017.11.016DOI Listing
November 2017

Preoperative Percutaneous Microwave Ablation of Long Bone Metastases Using a Parallel Medullary Approach for Reduction of Operative Blood Loss.

J Vasc Interv Radiol 2017 07;28(7):1069-1071

Department of Radiology, New York Presbyterian Hospital-Weill Cornell Medical Center, 525 E. 68th St., Box 141, New York, NY 10065.

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http://dx.doi.org/10.1016/j.jvir.2017.03.004DOI Listing
July 2017

Interventional radiologic techniques for screening, diagnosis and treatment of patients with renal artery stenosis.

Curr Urol Rep 2014 Jun;15(6):414

Department of Radiology, Division of Interventional Radiology, New York Presbyterian Hospital/Weill Cornell Medical College, 525 East 68th Street, Payson Pavillion 5th Floor, New York, NY, 10065, USA,

Renal artery stenosis resulting in renovascular hypertension or renal ischemia is a potentially treatable condition that results in increased morbidity and mortality, especially among older individuals. Sophisticated imaging techniques are used for screening and identification of affected patients to guide therapy. Treatment guidelines recommend intervention in patients with significant renal artery stenosis, although recent evidence has questioned the benefit of intervention in certain populations. Current research focuses on improving the specificity of imaging techniques and determining which imaging modalities best identify patients who will benefit from intervention.
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http://dx.doi.org/10.1007/s11934-014-0414-5DOI Listing
June 2014