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Hemangioendotelioma cérvico-mediastínico gigante de la vena subclavia
Giant Cervical and Mediastinal Hemangioendothelioma Arising from Subclavian Vein
María José Moyano-Rodríguez
, Florencio Quero-Valenzuela
Corresponding author
Departamento de Cirugía Torácica, Hospital Universitario Virgen de las Nieves, Granada, España
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C y F) Extensión cérvico-mediastínica tumoral (Ao: arco aórtico). D) Relación del tumor con el tronco arterial braquiocefálico derecho. E) Gradiente de bajo flujo en vasos subclavios.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Mujer de 20 años con tumoración cervical izquierda de un año de evolución y edema en miembro superior izquierdo.</p><p id="par0010" class="elsevierStylePara elsevierViewall">En la TAC se describe una masa de 6<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>7<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>11<span class="elsevierStyleHsp" style=""></span>cm desde región tiroidea izquierda hasta hilio pulmonar, desplazando medialmente la arteria carótida interna y posteriormente la arteria subclavia, en contacto con el cayado aórtico y la arteria pulmonar (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>D). En la RMN muestra realce con gadolinio (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>A-<span class="elsevierStyleSmallCaps">C</span>). En la angiografía de troncos supraaórticos existe un <span class="elsevierStyleItalic">stop</span> a nivel de vasos subclavios (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>E).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">El abordaje quirúrgico fue una combinación entre Dartevelle y Hemiclamshell. Se realizó ligadura de la vena yugular interna y el tronco venoso innominado. Se disecó y respetó la arteria subclavia y se procedió a la sección de la vena subclavia izquierda, origen de la tumoración, sin realizar reconstrucción dado el origen venoso y trombosis crónica. La histología fue hemangioendotelioma de alto grado<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">1</span></a>.</p><p id="par0020" class="elsevierStylePara elsevierViewall">La evolución postoperatoria fue favorable con una estancia hospitalaria de 9 días, sin complicaciones.</p><p id="par0025" class="elsevierStylePara elsevierViewall">La peculiaridad de nuestro caso es la rareza de este tipo de tumor y su forma presentación<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">1</span></a>, así como la gran extensión anatómica y la complejidad quirúrgica para su resección completa.</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" => 1275 "Ancho" => 1700 "Tamanyo" => 261049 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A y B) Desplazamiento medial y anteroposterior de la arteria carótida y de la arteria subclavia, respectivamente. C y F) Extensión cérvico-mediastínica tumoral (Ao: arco aórtico). D) Relación del tumor con el tronco arterial braquiocefálico derecho. E) Gradiente de bajo flujo en vasos subclavios.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:1 [ 0 => array:3 [ "identificador" => "bib0010" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mediastinal hemangioendothelioma: Case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Patrini" 1 => "L. Scolamiero" 2 => "R. Khiroya" 3 => "D. Lawrence" 4 => "E. Borg" 5 => "M. Hayward" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmcr.2017.05.005" "Revista" => array:6 [ "tituloSerie" => "Respir Med Case Rep" "fecha" => "2017" "volumen" => "22" "paginaInicial" => "19" "paginaFinal" => "23" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28626633" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005400000009/v1_201809020416/S0300289618300474/v1_201809020416/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/03002896/0000005400000009/v1_201809020416/S0300289618300474/v1_201809020416/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289618300474?idApp=UINPBA00003Z" ]
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