Letter to the Editor
Giant Teratoma Presenting With Pregnancy and Causing Respiratory Failure
Teratoma gigante manifestado en el embarazo y causante de insuficiencia respiratoria
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"titulo" => "Talking About Endobronchial Lipoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "251" "paginaFinal" => "252" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "A propósito del lipoma endobronquial" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan José Guelbenzu Zazpe, Elena Ramírez Gil, Ester Vilá Mayo" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Juan José" "apellidos" => "Guelbenzu Zazpe" ] 1 => array:2 [ "nombre" => "Elena" "apellidos" => "Ramírez Gil" ] 2 => array:2 [ "nombre" => "Ester" "apellidos" => "Vilá Mayo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289614002245" "doi" => "10.1016/j.arbres.2014.06.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" 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class="elsevierStyleTextfn">Letters to the Editor</span>" "titulo" => "Pneumomediastinum and Pneumopericardium in a Patient With Squamous Cell Lung Cancer" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "249" "paginaFinal" => "250" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neumomediastino y neumopericardio en un paciente con cáncer de pulmón espinocelular" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 996 "Ancho" => 1000 "Tamanyo" => 106913 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest computed tomography showing large 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class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Abdelatif" "apellidos" => "Benosman" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "El Hassane" "apellidos" => "Kabiri" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Thoracic Surgery, Mohamed V Military University Hospital, Rabat, Morocco" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Thoracic Surgery, Avicenne Hospital, Rabat, Morocco" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Centre d’étude doctorale des sciences de la vie et de la santé, Faculté de médecine, Université Mohammed V Souissi, Rabat, Morocco" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Teratoma gigante manifestado en el embarazo y causante de insuficiencia respiratoria" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1099 "Ancho" => 1696 "Tamanyo" => 324770 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Chest magnetic resonance image of a massive tumor in the left hemithorax, with fat, cystic spaces and organoid structures; (b) perioperative image of the tumor with hair-like structures, and (c) macroscopic image of the fully resected teratoma.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Pregnancy is associated with certain specific physiological adaptations and some atypical symptoms can be misdiagnosed during this period, leading to serious complications, particularly if pregnancy is associated with tumor disease.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of a 21-year-old pregnant woman, admitted to the emergency department of our hospital with severe chronic dyspnea, minimal hemoptysis and premature labor. She was in week 28 of gestation, gravida 1, para 0. Gynecological examination revealed dilated external cervical orifice. SaO<span class="elsevierStyleInf">2</span> was 90% and blood pressure 90<span class="elsevierStyleHsp" style=""></span>mmHg/60<span class="elsevierStyleHsp" style=""></span>mmHg. Chest auscultation revealed absence of respiratory sounds in the left hemithorax, which was totally opaque on minimal exposure chest X-ray. Thoracocentesis was performed immediately, and a left chest tube was left in place to reduce dyspnea, producing 1500 cc of serous-sanguineous pleural fluid. Corticosteroid (betamethasone) was administered to accelerate fetal lung maturation. Three days later, after stopping premature labor, a Cesarean section was successfully performed with the birth of a healthy boy. Chest computed tomography (CT) and magnetic resonance imaging (MRI) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) revealed a mediastinal tumor occupying the whole left hemithorax, with massive right mediastinal shift. The tumor contained cystic spaces and discrete areas of soft tissue and fat, consistent with probable mature teratoma. Serum alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) levels were normal. During posterolateral thoracotomy, the giant tumor was seen to have adhesions to the left lung, which was completely collapsed. The tumor contained organoid structures (hair), consistent with teratoma (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>b). Surprisingly, good lung re-expansion was achieved after full tumor resection (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>c). Histological diagnosis was mature teratoma. Positive estrogen and progesterone receptors were detected in resected tumor tissue.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Sixty percent of teratomas are located in the anterior mediastinum, and 88% are mature.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Mature teratoma is often asymptomatic and protrudes from one hemithorax. On CT, it is seen as a mass containing fat, calcifications or cystic changes. The benign nature of these lesions is confirmed by lack of activity on FDG-PET.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> MRI is useful for obtaining an accurate map of surrounding anatomical structures for surgical resection of the tumor.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The only curative treatment available for teratoma is surgical intervention, usually performed via sternotomy or thoracotomy, to relieve symptoms of compression and prevent transformation to malignancy.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Correct diagnosis and treatment are based on total tumor resection, although complete resection is not essential, since the local recurrence rate is low.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Adjuvant treatment is unnecessary, as prognosis for mature teratoma is good.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In pregnant women, radiation applied to the chest is considered safe if the abdomen is protected,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> so chest X-ray is formally indicated to avoid misdiagnosis of unexplained dyspnea in a pregnant woman.</p><p id="par0035" class="elsevierStylePara elsevierViewall">This large chest tumor causes decline in lung function, and pleural effusion may increase due to hormone changes and mechanical factors associated with pregnancy.</p><p id="par0040" class="elsevierStylePara elsevierViewall">To conclude, the appearance of these tumors during pregnancy is likely to involve real diagnostic and therapeutic issues.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of Interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: El Hammoumi M, Benosman A, Kabiri EH. Teratoma gigante manifestado en el embarazo y causante de insuficiencia respiratoria. Arch Bronconeumol. 2015;51:250–251.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1099 "Ancho" => 1696 "Tamanyo" => 324770 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Chest magnetic resonance image of a massive tumor in the left hemithorax, with fat, cystic spaces and organoid structures; (b) perioperative image of the tumor with hair-like structures, and (c) macroscopic image of the fully resected teratoma.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tératome mature du médiastin: à propos de deux cas" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. De Bournonville" 1 => "S. Maugendre" 2 => "C. Belleguic" 3 => "T. Corbineau" 4 => "H. Lena" 5 => "B. Desrues" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Pneumol Clin" "fecha" => "1999" "volumen" => "55" "paginaInicial" => "177" "paginaFinal" => "180" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10486840" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Growing teratoma syndrome of the ovary: a case report with FDG-PET findings" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Kikawa" 1 => "Y. Todo" 2 => "S. Minobe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1447-0756.2010.01439.x" "Revista" => array:6 [ "tituloSerie" => "J Obstet Gynaecol Res" "fecha" => "2011" "volumen" => "37" "paginaInicial" => "926" "paginaFinal" => "932" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21450035" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Giant mediastinal teratoma presenting with paroxysmal atrial fibrillation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Asteriou" 1 => "N. Barbetakis" 2 => "A. Kleontas" 3 => "D. Konstantinou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1510/icvts.2010.253039" "Revista" => array:6 [ "tituloSerie" => "Interact Cardiovasc Thorac Surg" "fecha" => "2011" "volumen" => "12" "paginaInicial" => "308" "paginaFinal" => "310" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21075832" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Germ cell tumors of the mediastinum" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Karangelis" 1 => "G. Kalafati" 2 => "V. Liouras" 3 => "N. Tsilimingas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1510/icvts.2010.249250A" "Revista" => array:5 [ "tituloSerie" => "Interact Cardiovasc Thorac Surg" "fecha" => "2010" "volumen" => "11" "paginaInicial" => "829" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21097461" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fetal doses from radiological examinations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.K. Osei" 1 => "K. Faulkner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1259/bjr.72.860.10624343" "Revista" => array:6 [ "tituloSerie" => "Br J Radiol" "fecha" => "1999" "volumen" => "72" "paginaInicial" => "773" "paginaFinal" => "780" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10624343" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005100000005/v2_201504270531/S1579212915000397/v2_201504270531/en/main.assets" "Apartado" => array:4 [ "identificador" => "14576" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005100000005/v2_201504270531/S1579212915000397/v2_201504270531/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915000397?idApp=UINPBA00003Z" ]
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| 2021 September | 43 | 32 | 75 |
| 2021 August | 39 | 30 | 69 |
| 2021 July | 66 | 29 | 95 |
| 2021 June | 70 | 28 | 98 |
| 2021 May | 79 | 21 | 100 |
| 2021 April | 147 | 44 | 191 |
| 2021 March | 110 | 37 | 147 |
| 2021 February | 53 | 16 | 69 |
| 2021 January | 46 | 12 | 58 |
| 2020 December | 38 | 10 | 48 |
| 2020 November | 58 | 14 | 72 |
| 2020 October | 42 | 8 | 50 |
| 2020 September | 55 | 16 | 71 |
| 2020 August | 45 | 16 | 61 |
| 2020 July | 38 | 17 | 55 |
| 2020 June | 51 | 10 | 61 |
| 2020 May | 56 | 11 | 67 |
| 2020 April | 47 | 18 | 65 |
| 2020 March | 42 | 11 | 53 |
| 2020 February | 68 | 21 | 89 |
| 2020 January | 32 | 16 | 48 |
| 2019 December | 64 | 29 | 93 |
| 2019 November | 49 | 23 | 72 |
| 2019 October | 47 | 12 | 59 |
| 2019 September | 47 | 11 | 58 |
| 2019 August | 42 | 12 | 54 |
| 2019 July | 65 | 20 | 85 |
| 2019 June | 46 | 12 | 58 |
| 2019 May | 78 | 17 | 95 |
| 2019 April | 67 | 37 | 104 |
| 2019 March | 57 | 14 | 71 |
| 2019 February | 39 | 18 | 57 |
| 2019 January | 47 | 10 | 57 |
| 2018 December | 33 | 9 | 42 |
| 2018 November | 87 | 28 | 115 |
| 2018 October | 104 | 30 | 134 |
| 2018 September | 47 | 13 | 60 |
| 2018 May | 13 | 0 | 13 |
| 2018 April | 35 | 3 | 38 |
| 2018 March | 33 | 4 | 37 |
| 2018 February | 26 | 6 | 32 |
| 2018 January | 93 | 9 | 102 |
| 2017 December | 56 | 13 | 69 |
| 2017 November | 22 | 5 | 27 |
| 2017 October | 19 | 6 | 25 |
| 2017 September | 12 | 7 | 19 |
| 2017 August | 23 | 13 | 36 |
| 2017 July | 18 | 16 | 34 |
| 2017 June | 33 | 12 | 45 |
| 2017 May | 25 | 5 | 30 |
| 2017 April | 14 | 5 | 19 |
| 2017 March | 13 | 3 | 16 |
| 2017 February | 15 | 8 | 23 |
| 2017 January | 8 | 3 | 11 |
| 2016 December | 18 | 12 | 30 |
| 2016 November | 24 | 14 | 38 |
| 2016 October | 25 | 13 | 38 |
| 2016 September | 25 | 21 | 46 |
| 2016 August | 32 | 13 | 45 |
| 2016 July | 24 | 16 | 40 |
| 2016 March | 3 | 0 | 3 |
| 2015 December | 3 | 0 | 3 |
| 2015 October | 40 | 4 | 44 |
| 2015 September | 34 | 5 | 39 |
| 2015 August | 43 | 28 | 71 |
| 2015 July | 0 | 1 | 1 |
| 2015 June | 1 | 0 | 1 |
| 2015 April | 2 | 0 | 2 |
Show all
