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Resultados del manejo conservador de un leiomioma endobronquial
Endobronquial leiomyoma: Outcome of conservative management
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El estudio radiológico y la fibrobroncoscopia revelaron la presencia de una tumoración redondeada, hipervascularizada y pediculada a 2<span class="elsevierStyleHsp" style=""></span>cm de la carina principal con una base de implantación de menos de 1<span class="elsevierStyleHsp" style=""></span>cm en profundidad en bronquio principal izquierdo.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Dado las características de la tumoración y el riesgo de hemorragia se decidió la exéresis de la misma bajo control de fibrobroncoscopia rígida, para biopsia y tratamiento de la oclusión.</p><p id="par0015" class="elsevierStylePara elsevierViewall">La paciente fue dada de alta a las 24<span class="elsevierStyleHsp" style=""></span>h sin ninguna incidencia. Una vez confirmado el diagnóstico de leiomioma endobronquial (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>) se decidió realizar seguimiento mediante fibrobroncoscopia flexible y pruebas de imagen. Tras 9 meses del tratamiento, la paciente se encuentra asintomática y libre de enfermedad.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">El leiomioma pulmonar es un tumor poco frecuente de origen mesodérmico<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a>. El tratamiento de elección es la resección a través del procedimiento más conservador posible. En los casos endoluminales, White et al.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> y Tan et al.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a>, defienden el tratamiento del leiomioma endobronquial mediante una técnica de exéresis endoscópica con endopinzas, electrocauterización o láser, dado que no hay descritas recidivas en las resecciones limitadas ni siembras a distancia.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 742 "Ancho" => 990 "Tamanyo" => 267765 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En la imagen se aprecia una tumoración fusocelular fasciculada subepitelial sin necrosis ni actividad mitótica (H&E ×4) que expresa inmunotinción positiva para actina de músculo liso (imagen inferior, AML ×10).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Leiomyomas of the lower respiratory tract" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.H. White" 1 => "N.B.N. Ibrahim" 2 => "C.P. Forrester-Wood" 3 => "K. Jeyasingham" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "1985" "volumen" => "40" "paginaInicial" => "306" "paginaFinal" => "311" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4023981" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Resection with preserved histologic morphology of a rare tumour via bronchoscopic cryosurgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.H. Tan" 1 => "A.M. Takano" 2 => "A.A. Hsu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.21037/jtd.2016.10.08" "Revista" => array:6 [ "tituloSerie" => "J Thorac Dis" "fecha" => "2016" "volumen" => "8" "paginaInicial" => "2964" "paginaFinal" => "2967" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27867576" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005300000009/v2_201708291404/S0300289617300613/v2_201708291404/es/main.assets" "Apartado" => array:4 [ "identificador" => "45361" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imagen clínica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005300000009/v2_201708291404/S0300289617300613/v2_201708291404/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617300613?idApp=UINPBA00003Z" ]
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