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En el caso de los vertebrales&#44; suele aparecer en individuos j&#243;venes y es mucho m&#225;s agresiva<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; Existe una preponderancia en los varones &#40;2&#44;7&#47;1 a 1&#44;6&#47;1&#41;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Los cordomas tienen una gran capacidad de recidiva y de malignizaci&#243;n&#44; a pesar de su naturaleza de lento crecimiento<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1-8</span></a>&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Observaci&#243;n cl&#237;nica</span><p id="par0020" class="elsevierStylePara elsevierViewall">Var&#243;n de 52<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; sin antecedentes de inter&#233;s&#44; con dolor tor&#225;cico dorsal de 6<span class="elsevierStyleHsp" style=""></span>meses de evoluci&#243;n&#46; Al no mejorar la cl&#237;nica del paciente&#44; se opt&#243; por la realizaci&#243;n de una resonancia magn&#233;tica &#40;RM&#41;&#44; previa radiograf&#237;a de t&#243;rax normal&#46; El diagn&#243;stico fue de hidatidosis costal con extensi&#243;n intrarraqu&#237;dea &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; Ante la duda de la naturaleza de dicho proceso&#44; se solicit&#243; una TC toracoabdominal&#44; hallando una masa paravertebral derecha de 88<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>95<span class="elsevierStyleHsp" style=""></span>mm de predominio qu&#237;stico y contornos lobulados&#44; morfolog&#237;a extrapleural e introducci&#243;n por el orificio foraminal derecho entre el sexto y el s&#233;ptimo arcos costales hacia el canal medular&#44; extendi&#233;ndose en localizaci&#243;n paravertebral desde el cuarto hasta el s&#233;ptimo arcos costales posteriores derechos&#44; afectando la grasa extrapleural y extendi&#233;ndose hacia la musculatura dorsal por los espacios intercostales y sin afectaci&#243;n costal&#46; Con todo ello&#44; la nueva sospecha diagn&#243;stica fue de sarcoma de partes blandas &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46; Se realiz&#243; una punci&#243;n-aspiraci&#243;n con aguja fina &#40;no diagn&#243;stica&#41;&#46; Dado el hallazgo intrarraqu&#237;deo de la masa&#44; se decidi&#243; realizar un abordaje combinado neuroquir&#250;rgico y tor&#225;cico&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Se realiz&#243; una resecci&#243;n y ex&#233;resis de la tumoraci&#243;n intrarraqu&#237;dea extradural con laminectom&#237;a D5-D6 y ex&#233;resis en bloque de una gran tumoraci&#243;n dependiente de la pleura parietal&#44; junto con resecci&#243;n at&#237;pica del segmento<span class="elsevierStyleHsp" style=""></span>6 y segmento posterior del l&#243;bulo superior derecho&#44; sumando una resecci&#243;n costal de la sexta y la s&#233;ptima costillas y sus respectivos espacios intercostales&#44; adem&#225;s del quinto espacio intercostal&#46; Se apreciaron otras lesiones contiguas a la gran tumoraci&#243;n que obligaron a su resecci&#243;n extrapleural&#46; Se realiz&#243; un raspado de la zona vertebral D6-D7&#46; Una vez resecada en bloque toda la pieza&#44; se pudieron observar lesiones diseminadas en la pleura diafragm&#225;tica y en la parietal sospechosas de implantes que se demostraron secundarias a la lesi&#243;n&#46; El defecto se reconstruy&#243; mediante material prot&#233;sico cubierto por el m&#250;sculo trapecio&#46; Fue dado de alta al s&#233;ptimo d&#237;a postoperatorio con una evoluci&#243;n cl&#237;nica satisfactoria y sin afectaci&#243;n neurol&#243;gica&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El estudio anatomopatol&#243;gico revel&#243; la presencia de un cordoma condroide de 12&#44;8<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>7&#44;3<span class="elsevierStyleHsp" style=""></span>cm&#44; que respetaba la musculatura esquel&#233;tica subyacente y tambi&#233;n el par&#233;nquima pulmonar resecado&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Tras tratamiento con radioterapia adyuvante e inhibidores de EGFR&#44; en estos momentos la enfermedad est&#225; estabilizada y el paciente permanece sin cl&#237;nica neurol&#243;gica&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discusi&#243;n</span><p id="par0040" class="elsevierStylePara elsevierViewall">La presencia de cordomas a nivel de las v&#233;rtebras tor&#225;cicas es una entidad poco frecuente &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Su s&#237;ntoma principal es el dolor de tipo mec&#225;nico pero que progresa con aparici&#243;n de sintomatolog&#237;a neurol&#243;gica por su crecimiento&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">La TC sirve para caracterizar la afectaci&#243;n de los cuerpos vertebrales&#44; la presencia de un tumor paravertebral&#44; la afectaci&#243;n intraespinal y la del espacio discal<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; La RM ayuda a la clarificaci&#243;n de la extensi&#243;n epidural&#44; la compresi&#243;n medular o bien la presencia de met&#225;stasis epidurales<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;5</span></a>&#46; La utilizaci&#243;n de la PET o PET-TC est&#225; muy discretamente referenciada en la literatura tanto para el diagn&#243;stico inicial como para el seguimiento&#44; siendo su comportamiento como el de una lesi&#243;n con incremento de la captaci&#243;n de la glucosa<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Seg&#250;n su histopatolog&#237;a<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#44; se clasifican en&#58; cl&#225;sico&#44; condroide&#44; desdiferenciado&#44; sarcomatoide&#44; intradural y extrarraqu&#237;deo &#40;mediast&#237;nico&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Su diagn&#243;stico se afianza por la positividad de la citoqueratina<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> y la expresi&#243;n del gen <span class="elsevierStyleItalic">brachyury</span><a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46; Dicho gen es un biomarcador espec&#237;fico para permitir la diferenciaci&#243;n entre cordomas y condrosarcomas<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;10</span></a>&#44; siendo motivo de estudio de terapias g&#233;nicas&#46; En esa misma l&#237;nea se est&#225;n investigando otras alternativas&#44; como el uso de inhibidores del EGFR &#40;erlotinib y la combinaci&#243;n de gefitinib-cetuximab&#41;&#44; con resultados esperanzadores<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">El tratamiento ideal pasa por un abordaje quir&#250;rgico agresivo&#44; intentando conseguir una resecci&#243;n en bloque con m&#225;rgenes quir&#250;rgicos libres lo m&#225;s amplios posibles&#44; ya que de otra manera la recidiva ser&#225; la norma<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;5</span></a>&#44; no siendo siempre posible dada la extensi&#243;n de la lesi&#243;n y&#47;o las estructuras afectadas&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Sin m&#225;rgenes adecuados&#44; es preciso realizar una radioterapia adyuvante para intentar aumentar una hipot&#233;tica supervivencia libre de enfermedad<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; La tasa de recidiva local est&#225; en torno al 26-68&#37;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; Los cordomas pueden metastatizar en el 20 al 60&#37; de los casos<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> &#40;piel&#44; pulm&#243;n&#44; sistema linf&#225;tico&#8230;&#41;&#46; En general&#44; la supervivencia a 5<span class="elsevierStyleHsp" style=""></span>a&#241;os de este tumor se halla entre el 10 y el 70&#37;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;8</span></a>&#46;</p></span></span>"
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          "identificador" => "xres287870"
          "titulo" => "Abstract"
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          "titulo" => "Keywords"
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        4 => array:2 [
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          "titulo" => "Introducci&#243;n"
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        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Observaci&#243;n cl&#237;nica"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Discusi&#243;n"
        ]
        7 => array:1 [
          "titulo" => "Bibliograf&#237;a"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2012-11-30"
    "fechaAceptado" => "2013-03-13"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec271316"
          "palabras" => array:4 [
            0 => "Cordoma condroide"
            1 => "Tumor vertebral"
            2 => "Clasificaci&#243;n"
            3 => "Tratamiento"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec271315"
          "palabras" => array:4 [
            0 => "Chondroid chordoma"
            1 => "Vertebral tumour"
            2 => "Classification"
            3 => "Treatment"
          ]
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      ]
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    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El cordoma condroide de localizaci&#243;n vertebral tor&#225;cica es un tipo de tumor que constituye una aut&#233;ntica rareza&#46; La incidencia anual del cordoma condroide se cifra en 0&#44;1&#47;100&#46;000<span class="elsevierStyleHsp" style=""></span>habitantes&#44; y la afectaci&#243;n tor&#225;cica se aprecia en el 2 al 5&#37; de los casos&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Su diagn&#243;stico definitivo se ve complicado por su semejanza con otros tumores como los condrosarcomas&#44; por lo que es preciso acudir al estudio inmunohistoqu&#237;mico&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Su capacidad de recidiva y la tendencia a la malignizaci&#243;n a pesar de su naturaleza de lento crecimiento provocan que su tratamiento&#44; predominantemente quir&#250;rgico&#44; sea de una complejidad nada desde&#241;able&#46; Su comportamiento evolutivo tan agresivo est&#225; siendo motivo de estudio a nivel molecular y gen&#233;tico para la elaboraci&#243;n de nuevas terapias oncol&#243;gicas m&#233;dicas con el fin de complementar la cirug&#237;a y la radioterapia&#44; cuando estas sean aplicables&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se presenta un caso de localizaci&#243;n tor&#225;cica vertebral e intrapleural&#44; as&#237; como el tratamiento practicado&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Chondroid chordoma is an extremely rare tumour with an annual incidence of around 0&#46;1 cases per 100&#44;000<span class="elsevierStyleHsp" style=""></span>population&#46; Involvement of the thoracic vertebrae may be present in 2-5&#37; of cases&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Definitive diagnosis usually requires a suitable distinction between this and other mesenchymal tumours such as chondrosarcomas&#44; so immunohistochemical analysis is virtually mandatory&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In spite of its slow-growing nature&#44; chondroid chordoma tends to relapse&#44; and it may eventually become malignant&#44; often jeopardising the patient&#39;s prognosis&#46; Although surgery remains the main therapeutic approach&#44; research into the molecular and genetic aspects of this tumour is ongoing&#46; These new advances are likely to improve future oncology therapies by complementing surgery and radiotherapy&#44; changing the currently poor prognosis&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">We report the case of a patient with a chondroid chordoma involving the thoracic vertebrae and pleural cavity&#44; and the treatment performed&#46;</p>"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Resonancia magn&#233;tica&#58; masa con afectaci&#243;n intrarraqu&#237;dea &#40;flecha roja&#41;&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Autor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">A&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Cordomas vertebrales&#47;total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Utne y Pugh&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1955&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#47;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Higinbothan&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1967&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#47;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cummings&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1983&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Volpe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1983&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rich&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1985&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">O&#8217;Neill&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1985&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Amendola&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1986&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Azzarelli&nbsp;\t\t\t\t\t\t\n
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Nota clínica
Cordoma condroide de localización atípica
Chondroid Chordoma in an Atypical Location
Iñigo Royo Crespoa,
Corresponding author
ircres@hotmail.com

Autor para correspondencia.
, Juan José Rivas de Andrésa, Raúl Embún Flora, Severiano Cortés Francob
a Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
b Servicio de Neurocirugía, Hospital Universitario Miguel Servet, Zaragoza, España
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extendi&#233;ndose en localizaci&#243;n paravertebral desde el cuarto hasta el s&#233;ptimo arcos costales posteriores derechos&#44; afectando la grasa extrapleural y extendi&#233;ndose hacia la musculatura dorsal por los espacios intercostales y sin afectaci&#243;n costal&#46; Con todo ello&#44; la nueva sospecha diagn&#243;stica fue de sarcoma de partes blandas &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46; Se realiz&#243; una punci&#243;n-aspiraci&#243;n con aguja fina &#40;no diagn&#243;stica&#41;&#46; Dado el hallazgo intrarraqu&#237;deo de la masa&#44; se decidi&#243; realizar un abordaje combinado neuroquir&#250;rgico y tor&#225;cico&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Se realiz&#243; una resecci&#243;n y ex&#233;resis de la tumoraci&#243;n intrarraqu&#237;dea extradural con laminectom&#237;a D5-D6 y ex&#233;resis en bloque de una gran tumoraci&#243;n dependiente de la pleura parietal&#44; junto con resecci&#243;n at&#237;pica del segmento<span class="elsevierStyleHsp" style=""></span>6 y segmento posterior del l&#243;bulo superior derecho&#44; sumando una resecci&#243;n costal de la sexta y la s&#233;ptima costillas y sus respectivos espacios intercostales&#44; adem&#225;s del quinto espacio intercostal&#46; Se apreciaron otras lesiones contiguas a la gran tumoraci&#243;n que obligaron a su resecci&#243;n extrapleural&#46; Se realiz&#243; un raspado de la zona vertebral D6-D7&#46; Una vez resecada en bloque toda la pieza&#44; se pudieron observar lesiones diseminadas en la pleura diafragm&#225;tica y en la parietal sospechosas de implantes que se demostraron secundarias a la lesi&#243;n&#46; El defecto se reconstruy&#243; mediante material prot&#233;sico cubierto por el m&#250;sculo trapecio&#46; Fue dado de alta al s&#233;ptimo d&#237;a postoperatorio con una evoluci&#243;n cl&#237;nica satisfactoria y sin afectaci&#243;n neurol&#243;gica&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El estudio anatomopatol&#243;gico revel&#243; la presencia de un cordoma condroide de 12&#44;8<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>7&#44;3<span class="elsevierStyleHsp" style=""></span>cm&#44; que respetaba la musculatura esquel&#233;tica subyacente y tambi&#233;n el par&#233;nquima pulmonar resecado&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Tras tratamiento con radioterapia adyuvante e inhibidores de EGFR&#44; en estos momentos la enfermedad est&#225; estabilizada y el paciente permanece sin cl&#237;nica neurol&#243;gica&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discusi&#243;n</span><p id="par0040" class="elsevierStylePara elsevierViewall">La presencia de cordomas a nivel de las v&#233;rtebras tor&#225;cicas es una entidad poco frecuente &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Su s&#237;ntoma principal es el dolor de tipo mec&#225;nico pero que progresa con aparici&#243;n de sintomatolog&#237;a neurol&#243;gica por su crecimiento&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">La TC sirve para caracterizar la afectaci&#243;n de los cuerpos vertebrales&#44; la presencia de un tumor paravertebral&#44; la afectaci&#243;n intraespinal y la del espacio discal<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; La RM ayuda a la clarificaci&#243;n de la extensi&#243;n epidural&#44; la compresi&#243;n medular o bien la presencia de met&#225;stasis epidurales<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;5</span></a>&#46; La utilizaci&#243;n de la PET o PET-TC est&#225; muy discretamente referenciada en la literatura tanto para el diagn&#243;stico inicial como para el seguimiento&#44; siendo su comportamiento como el de una lesi&#243;n con incremento de la captaci&#243;n de la glucosa<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Seg&#250;n su histopatolog&#237;a<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#44; se clasifican en&#58; cl&#225;sico&#44; condroide&#44; desdiferenciado&#44; sarcomatoide&#44; intradural y extrarraqu&#237;deo &#40;mediast&#237;nico&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Su diagn&#243;stico se afianza por la positividad de la citoqueratina<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> y la expresi&#243;n del gen <span class="elsevierStyleItalic">brachyury</span><a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46; Dicho gen es un biomarcador espec&#237;fico para permitir la diferenciaci&#243;n entre cordomas y condrosarcomas<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;10</span></a>&#44; siendo motivo de estudio de terapias g&#233;nicas&#46; En esa misma l&#237;nea se est&#225;n investigando otras alternativas&#44; como el uso de inhibidores del EGFR &#40;erlotinib y la combinaci&#243;n de gefitinib-cetuximab&#41;&#44; con resultados esperanzadores<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">El tratamiento ideal pasa por un abordaje quir&#250;rgico agresivo&#44; intentando conseguir una resecci&#243;n en bloque con m&#225;rgenes quir&#250;rgicos libres lo m&#225;s amplios posibles&#44; ya que de otra manera la recidiva ser&#225; la norma<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;5</span></a>&#44; no siendo siempre posible dada la extensi&#243;n de la lesi&#243;n y&#47;o las estructuras afectadas&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Sin m&#225;rgenes adecuados&#44; es preciso realizar una radioterapia adyuvante para intentar aumentar una hipot&#233;tica supervivencia libre de enfermedad<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; La tasa de recidiva local est&#225; en torno al 26-68&#37;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; Los cordomas pueden metastatizar en el 20 al 60&#37; de los casos<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> &#40;piel&#44; pulm&#243;n&#44; sistema linf&#225;tico&#8230;&#41;&#46; En general&#44; la supervivencia a 5<span class="elsevierStyleHsp" style=""></span>a&#241;os de este tumor se halla entre el 10 y el 70&#37;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;8</span></a>&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
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          "identificador" => "xpalclavsec271316"
          "titulo" => "Palabras clave"
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        2 => array:2 [
          "identificador" => "xres287870"
          "titulo" => "Abstract"
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        3 => array:2 [
          "identificador" => "xpalclavsec271315"
          "titulo" => "Keywords"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introducci&#243;n"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Observaci&#243;n cl&#237;nica"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Discusi&#243;n"
        ]
        7 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2012-11-30"
    "fechaAceptado" => "2013-03-13"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec271316"
          "palabras" => array:4 [
            0 => "Cordoma condroide"
            1 => "Tumor vertebral"
            2 => "Clasificaci&#243;n"
            3 => "Tratamiento"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec271315"
          "palabras" => array:4 [
            0 => "Chondroid chordoma"
            1 => "Vertebral tumour"
            2 => "Classification"
            3 => "Treatment"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El cordoma condroide de localizaci&#243;n vertebral tor&#225;cica es un tipo de tumor que constituye una aut&#233;ntica rareza&#46; La incidencia anual del cordoma condroide se cifra en 0&#44;1&#47;100&#46;000<span class="elsevierStyleHsp" style=""></span>habitantes&#44; y la afectaci&#243;n tor&#225;cica se aprecia en el 2 al 5&#37; de los casos&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Su diagn&#243;stico definitivo se ve complicado por su semejanza con otros tumores como los condrosarcomas&#44; por lo que es preciso acudir al estudio inmunohistoqu&#237;mico&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Su capacidad de recidiva y la tendencia a la malignizaci&#243;n a pesar de su naturaleza de lento crecimiento provocan que su tratamiento&#44; predominantemente quir&#250;rgico&#44; sea de una complejidad nada desde&#241;able&#46; Su comportamiento evolutivo tan agresivo est&#225; siendo motivo de estudio a nivel molecular y gen&#233;tico para la elaboraci&#243;n de nuevas terapias oncol&#243;gicas m&#233;dicas con el fin de complementar la cirug&#237;a y la radioterapia&#44; cuando estas sean aplicables&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se presenta un caso de localizaci&#243;n tor&#225;cica vertebral e intrapleural&#44; as&#237; como el tratamiento practicado&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Chondroid chordoma is an extremely rare tumour with an annual incidence of around 0&#46;1 cases per 100&#44;000<span class="elsevierStyleHsp" style=""></span>population&#46; Involvement of the thoracic vertebrae may be present in 2-5&#37; of cases&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Definitive diagnosis usually requires a suitable distinction between this and other mesenchymal tumours such as chondrosarcomas&#44; so immunohistochemical analysis is virtually mandatory&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In spite of its slow-growing nature&#44; chondroid chordoma tends to relapse&#44; and it may eventually become malignant&#44; often jeopardising the patient&#39;s prognosis&#46; Although surgery remains the main therapeutic approach&#44; research into the molecular and genetic aspects of this tumour is ongoing&#46; These new advances are likely to improve future oncology therapies by complementing surgery and radiotherapy&#44; changing the currently poor prognosis&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">We report the case of a patient with a chondroid chordoma involving the thoracic vertebrae and pleural cavity&#44; and the treatment performed&#46;</p>"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Resonancia magn&#233;tica&#58; masa con afectaci&#243;n intrarraqu&#237;dea &#40;flecha roja&#41;&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Autor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">A&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Cordomas vertebrales&#47;total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Utne y Pugh&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1955&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#47;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Higinbothan&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1967&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#47;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cummings&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1983&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Volpe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1983&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rich&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1985&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">O&#8217;Neill&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1985&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Amendola&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1986&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Azzarelli&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1988&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coffin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1993&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#47;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Autor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">A&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Cordomas vertebrales&#47;cordomas espinales&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sundaresan&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1979&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#47;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Meyer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1984&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#47;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bjornsson&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1993&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#47;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Boriani&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;52&nbsp;\t\t\t\t\t\t\n
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ISSN: 03002896
Original language: Spanish
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