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Pneumomediastinum and Massive Subcutaneous Emphysema Due to Lung Neoplasm
Neumomediastino y enfisema subcutáneo masivo secundarios a neoplasia pulmonar
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Voluminosa masa en lóbulo superior derecho, y discreto enfisema subcutáneo cervical. C) TC de tórax (corte axial, ventana de mediastino). 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Peripheral cavitary pulmonary nodules (arrows) in the right and left upper lobe and right pneumothorax.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Horacio Matías Castro, Clara Lucia Torres Cabreros, Esteban Javier Wainstein" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Horacio Matías" "apellidos" => "Castro" ] 1 => array:2 [ "nombre" => "Clara Lucia" "apellidos" => "Torres Cabreros" ] 2 => array:2 [ "nombre" => "Esteban Javier" "apellidos" => "Wainstein" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289619302923" "doi" => "10.1016/j.arbres.2019.06.017" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289619302923?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212920300999?idApp=UINPBA00003Z" "url" => "/15792129/0000005600000007/v1_202007070735/S1579212920300999/v1_202007070735/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212920300975" "issn" => "15792129" "doi" => "10.1016/j.arbr.2019.06.023" "estado" => "S300" "fechaPublicacion" => "2020-07-01" "aid" => "2204" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2020;56:455" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Squamous Cell Carcinoma of the Chest Wall in Open Thoracostomy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "455" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Carcinoma epidermoide de pared torácica en una toracostomía abierta" ] ] "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" => 1041 "Ancho" => 1196 "Tamanyo" => 163875 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Tumor protruding through the permanent open thoracostomy space. 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Voluminous mass in right upper lobe, and minor cervical subcutaneous emphysema. (C) Chest CT (axial slice, mediastinum window). Resorption of posterior costal arches at the site of the mass, pneumomediastinum and massive subcutaneous emphysema.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 69-year-old man, former smoker, who attended the emergency department with constitutional symptoms and pain in the right shoulder. Chest radiograph (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B) revealed a mass in the right upper lobe. His symptoms were controlled and he was referred to the respiratory medicine department, where positron emission tomography and chest computed tomography (CT) were performed, showing destruction of the ribs by the mass with incipient signs of subcutaneous emphysema. A few days after the biopsy (epidermoid carcinoma), he presented in our hospital with significant clinical deterioration. Examination revealed cervicofacial swelling, thoracocervical crackles, and hypophonesis in right fields, with tachypnea and arterial oxygen saturation of 93%. Urgent CT was performed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C), showing pneumomediastinum and massive subcutaneous emphysema. The patient was admitted to the oncology department, where 2 subcutaneous Penrose® drainage tubes were inserted, producing clinical and radiological improvement.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Pneumomediastinum with subcutaneous emphysema due to lung cancer is a rare entity attributed to tracheomediastinal fistula.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> In our case, rib resorption had caused a subcutaneous bronchopleural fistula. Treatment of uncomplicated emphysema is conservative (oxygen therapy, analgesia, antibiotics), but in case of hemodynamic or respiratory involvement, skin incisions and drainage tubes can be used to release air.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Láinez-Ramos-Bossini AJ, Pérez-García MC, Rueda-Cáceres MT. Neumomediastino y enfisema subcutáneo masivo secundarios a neoplasia pulmonar. Arch Bronconeumol. 2020;56:4560.</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" => 446 "Ancho" => 1500 "Tamanyo" => 86200 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A and B) Plain chest X-ray in PA and lateral projections. Voluminous mass in right upper lobe, and minor cervical subcutaneous emphysema. (C) Chest CT (axial slice, mediastinum window). Resorption of posterior costal arches at the site of the mass, pneumomediastinum and massive subcutaneous emphysema.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neumomediastino y neumopericardio en un paciente con cáncer de pulmón espinocelular" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Kara" 1 => "S. Klimesova" 2 => "N. Pauk" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2014.04.014" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2015" "volumen" => "51" "paginaInicial" => "249" "paginaFinal" => "250" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25022786" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subcutaneous emphysema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.H. Chotirmall" 1 => "R.K. Morgan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bcr-2013-201127" "Revista" => array:3 [ "tituloSerie" => "BMJ Case Rep" "fecha" => "2014" "volumen" => "2014" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005600000007/v1_202007070735/S1579212920300987/v1_202007070735/en/main.assets" "Apartado" => array:4 [ "identificador" => "60604" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005600000007/v1_202007070735/S1579212920300987/v1_202007070735/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212920300987?idApp=UINPBA00003Z" ]
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