Roxana Diba

University of Texas MD Anderson Cancer Center, Houston, TX, United States

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Publications (12)17.1 Total impact

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    ABSTRACT: An observational case series to assess the value of positron emission tomography (PET) in staging ocular adnexal lymphomas and evaluating their response to therapy. The clinical records of 16 consecutive patients with ocular adnexal lymphoma for whom pretreatment and posttreatment PET scans and corresponding computed tomography (CT) and magnetic resonance imaging (MRI) scans were available were compared. Pretreatment PET scans demonstrated fluorine 18-fluorodeoxyglucose (FDG) positive lesions in 15 orbits of 12 patients. In 1 patient with low-grade follicular lymphoma of the orbit, PET revealed an additional focus of lymphoma in the deltoid muscle that was missed on clinical examination and conventional radiography. All of the posttreatment PET scans showed complete resolution of FDG uptake, suggesting good response to therapy. However, posttreatment CT and MRI scans demonstrated residual masses in 3 patients. PET is valuable for initial staging of ocular adnexal lymphomas and may be a good adjunct to conventional imaging in evaluation of response to therapy.
    Ophthalmic Surgery Lasers and Imaging 01/2007; 38(4):319-25. · 1.46 Impact Factor
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    ABSTRACT: The aim of this study is to investigate whether there are any abnormalities in the in vivo expression of retinoid acid receptors (RAR-alpha, RAR-beta and RAR-gamma) and retinoid X receptors (RXR-alpha, RXR-beta and RXR-gamma) in sebaceous cell carcinoma. Expression of retinoid receptors in paired specimens of cancerous tissues (n = 10) and adjacent normal tissues (n = 10) from 10 patients with sebaceous cell carcinoma was studied immunohistochemically by using anti-retinoid receptor antibodies. In eight of the 10 normal tissue samples, all six receptors were expressed. In the other two samples, all receptors were expressed except RAR-gamma (one sample) or RXR-gamma (two samples). Five tumours (50%) lacked RAR-alpha; RAR-alpha expression was lower in tumours than in normal tissues in eight of 10 cases. RAR-beta was expressed in the cytoplasm of nine of 10 tumours; RAR-beta expression was at least as high in tumours as in normal tissue in eight of 10 cases. Two tumours lacked RAR-gamma; three tumours had lower RAR-gamma expression than paired normal epithelium; four had the same RAR-gamma expression, and one had higher RAR-gamma expression. RXR-alpha expression was strong in all normal tissues and tumour samples. Ten tumours lacked RXR-beta and all 10 tumours lacked RXR-gamma expression. Diminished RXR-beta and RXR-gamma expression might be related to the development of sebaceous cell carcinoma. Additional studies are required to establish whether the defects in RAR expression in sebaceous cell carcinoma might affect the potential response of this tumour to treatment with retinoids.
    Journal of Cutaneous Pathology 02/2006; 33(1):10-7. · 1.77 Impact Factor
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    ABSTRACT: To determine whether the tyrosine kinase epidermal growth factor receptor (EGFR) is expressed in squamous cell carcinoma of the conjunctiva. A retrospective, observational case series of 5 patients with biopsy-proven conjunctival squamous cell carcinoma treated at one institution between January 1996 and April 2004. Medical records and tissue specimens from the 5 patients were reviewed. A control specimen of normal conjunctiva was also obtained from one of the 5 patients. Immunohistochemical analysis was performed using antibodies against EGFR. Immunohistochemical staining showed that EGFR expression was moderate to strong in all tissue specimens, both in the normal mucosa and in the in situ and invasive components of the conjunctival squamous cell carcinomas. An intense expression of EGFR occurs in squamous cell carcinoma of the conjunctiva. Further study is needed to determine whether an EGFR inhibitor that targets this expression would have potential therapeutic benefit in treating squamous cell carcinoma of the conjunctiva.
    Ophthalmic Plastic and Reconstructive Surgery 01/2006; 22(2):113-5. · 0.91 Impact Factor
  • Dan S Gombos, Roxana Diba
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    ABSTRACT: The purpose of this study was to estimate the number of retinoblastoma cases anticipated each year in various urban and rural areas in Texas. We obtained the most recent data on the number of live births in Texas from the Texas Department of Health. Using those data and the retinoblastoma incidence rate of 1 in 15,000 live births, we estimated that 26 cases of the disease will be diagnosed in Texas each year. Nearly half of those cases will occur in infants in rural areas of the state. We compared those values with data from the Texas Cancer Registry. Primary care physicians, particularly in rural areas of Texas, must screen patients for retinoblastoma and consider arrangements for rapid referral when the diagnosis is suspected.
    Texas medicine 08/2005; 101(7):70-2.
  • Dan S Gombos, Roxana Diba
    Texas medicine 08/2005; 101(7):9.
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    ABSTRACT: The purpose of this study was to evaluate the outcomes of dacryocystorhinostomy (DCR) in patients with head and neck tumors. The clinical records of all 31 patients with head and neck tumors who underwent DCR for nasolacrimal duct blockage at The University of Texas M. D. Anderson Cancer Center between 1999 and 2003 were retrospectively reviewed. The tumor diagnoses were squamous cell carcinoma (n = 18), chondrosarcoma (n = 3), sinonasal carcinoma (n = 2), adenoid cystic carcinoma (n = 2), sinonasal papilloma (n = 2), esthesioneuroblastoma (n = 1); hemangiopericytoma (n = 1); ameloblastoma (n = 1), and osteosarcoma (n = 1). Twenty-eight patients had a maxillectomy or other sinus surgeries, 10 had radiotherapy, and 14 had chemotherapy and radiotherapy before DCR. All 31 patients (35 eyes) experienced improvement of epiphora after DCR, but five patients (six eyes) had recurrent nasolacrimal duct blockage develop during the study period. Two patients had mild wound infections; none had osteoradionecrosis. DCR alleviates nasolacrimal duct blockage in most patients with head and neck tumors and is not associated with unusual complications in this setting.
    Head & Neck 02/2005; 27(1):72-5. · 2.83 Impact Factor
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    ABSTRACT: OBJECTIVE: To examine the expression of molecules targeted by imatinib mesylate (STI571;Gleevec) and epidermal growth factor receptor (EGFR) inhibitors in orbital lymphangiomas. DESIGN: Retrospective observational case series. PARTICIPANTS: Six patients with orbital lymphangioma treated at four institutions between March 2000 and December 2002. METHODS: Tissue specimens and medical records from six patients were collected. Immunohistochemical analysis was performed using antibodies against c-kit and platelet-derived growth factor receptor (PDGFR) alpha and beta and EGFR tyrosine kinase.
    Orbit 01/2005; 23(4):263-9.
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    ABSTRACT: To determine the frequency and location of regional lymph node metastasis in patients with squamous cell carcinoma (SCC) of the eyelid and periocular skin. Patterns of distant metastasis were also investigated. Retrospective case series. One hundred eleven patients treated at The University of Texas M. D. Anderson Cancer Center for SCC of the eyelid and periocular skin between 1952 and 2000. The clinical records of the 111 patients were retrospectively reviewed. The clinical characteristics analyzed included age, gender, location of lesion, treatment modalities, patterns of regional nodal and distant metastasis, and perineural invasion. Follow-up time ranged from 6 to 484 months (median, 76.6). Incidence of regional lymph node metastasis. The most common sites of SCC were the lower eyelid (54 patients [48.6%]), the medial canthus (40 patients [36.0%]), and the upper eyelid (25 patients [22.5%]). Local treatment of SCC consisted of wide local excision with frozen section analysis to ensure negative margins in 96 patients (86.4%), radiotherapy (without surgery) in 7 patients, and primary exenteration because of extensive tumor in 7 patients. Local recurrence occurred in 41 patients (36.9%). Twenty-seven patients (24.3%) had regional nodal metastasis during the study period. Sixteen of these patients had regional lymph node metastasis at the time of the initial presentation to M. D. Anderson Cancer Center. Eleven developed regional nodal disease later. Seven patients (6.2%) had distant metastasis during the study period. Nine patients (8.1%) had perineural invasion. This study indicates that the overall rate of regional lymph node metastasis in patients with SCC of the eyelid or periocular skin may be as high as 24%. Thus, careful surveillance of the regional lymph nodes is an important aspect of the initial management of eyelid or periocular skin SCC. Consideration could be given to studying sentinel lymph node biopsy as a technique to stage SCC of the eyelid or periocular skin more accurately, especially in patients with recurrent, large, or highly invasive lesions or with perineural invasion.
    Ophthalmology 11/2004; 111(10):1930-2. · 5.56 Impact Factor
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    ABSTRACT: A 63-year-old woman had a diffuse uveal melanoma with massive extension in the orbit and optic chiasm. She received palliative radiation therapy. The importance of careful inspection of the enucleated specimen and postenucleation imaging studies to delineate the extent of the uveal tumor are underscored in this case. Treatment options may include skull base surgery or palliative radiotherapy.
    Ophthalmic Plastic and Reconstructive Surgery 10/2004; 20(5):387-90. · 0.91 Impact Factor
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    ABSTRACT: To describe one center's experience with sentinel lymph node (SLN) biopsy in patients with eyelid and conjunctival malignancies performed with a smaller volume of technetium than was initially used and a small incision directly overlying the sentinel node(s). A noncomparative interventional case series of 13 patients with clinically negative regional lymph nodes who underwent SLN biopsy for eyelid or conjunctival malignancies at The University of Texas M. D. Anderson Cancer Center between May 2002 and July 2003. Preoperative lymphoscintigraphy was performed with an injection of 0.3 mCi of technetium Tc-99m sulfur colloid in a volume of 0.2 mL. Images were taken as soon as the first SLN was detected through the gamma camera. Intraoperative mapping was performed with the same volume and concentration of technetium Tc-99m sulfur colloid along with an injection of isosulfan blue dye. Five patients had conjunctival melanoma, 6 had sebaceous cell carcinoma of the eyelid, and 2 had eyelid melanoma. SLN(s) were identified in all patients. In 12 patients, more than 1 SLN was identified. During surgery, no SLNs were blue. One patient with conjunctival melanoma had an SLN that was positive on histologic examination. There were no ocular or extraocular complications from the procedure except for mild temporary weakness of the marginal mandibular branch of the facial nerve in 2 patients that resolved completely within 4 to 6 weeks and without any further intervention. None of the patients had permanent blue tattooing of the conjunctival surface or eyelid skin. Our experience suggests that lymphoscintigraphy and SLN biopsy with a small volume of technetium Tc-99m sulfur colloid and small incisions, even without the use of the blue dye, can identify SLNs in patients with conjunctival and eyelid malignancies, and can be performed safely.
    Ophthalmic Plastic and Reconstructive Surgery 08/2004; 20(4):291-5. · 0.91 Impact Factor
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    Eye 08/2004; 18(7):760-2. · 1.82 Impact Factor
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    ABSTRACT: To evaluate the outcomes among patients with adenoid cystic carcinoma of the lacrimal gland treated at various stages of their disease at a tertiary care cancer center. A retrospective case series of 20 patients with adenoid cystic carcinoma of the lacrimal gland treated at a single institution between 1952 and 2002. Clinical records were available for all 20 patients; histologic sections from 12 of the 20 patients were available for review. Disease-free survival was measured from the completion of treatment; overall survival was measured from the date of initial diagnosis. The study included 6 men and 14 women. The mean age at diagnosis was 39.5 years. The median follow-up time was 34 months (range, 6 to 264 months). The local/regional treatment modalities included exenteration with bone removal and radiation therapy (RT) in 5 patients, exenteration with RT (no bone removal) in 8 patients, exenteration (no RT or bone removal) in 1 patient, exenteration with bone removal (no RT) in 1 patient, local resection with RT in 3 patients, and local resection without RT in 2 patients. Overall, 16 patients had RT as part of their treatment regimen. Seven patients (35%) had local recurrence. Sixteen patients (80%) had distant metastasis during the study period. At the time of this report, 13 (65%) of the patients had died of disease. The median disease-free survival for the entire group was 18 months. Eight patients had a predominantly basaloid histologic pattern. Ten patients had verifiable histologic evidence of perineural invasion. This study underscores the generally grave prognosis for patients with adenoid cystic carcinoma of the lacrimal gland and the difficulty in making any conclusive recommendations for local therapy for this disease.
    Ophthalmic Plastic and Reconstructive Surgery 02/2004; 20(1):22-6. · 0.91 Impact Factor

Publication Stats

168 Citations
17.10 Total Impact Points

Institutions

  • 2004–2007
    • University of Texas MD Anderson Cancer Center
      • • Department of Nuclear Medicine
      • • Department of Plastic Surgery
      • • Department of Head and Neck Surgery
      Houston, TX, United States