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Successful Surgical Treatment of a Giant Pulmonary Vein Ewing's Sarcoma Invading Left Atrium
Tratamiento quirúrgico exitoso de un sarcoma de Ewing gigante de la vena pulmonar que invade la aurícula izquierda
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Pleural effusion is thick and yellow as it is poured into the specimen cup. The fluid has thixotropic properties where it stable at rest but appears to become more fluid when agitated. Limited pleural fluid analysis revealed an elevated total protein of 3.1, cell count of 950 WBCS with 1 neutrophil, 98 mononculear and 1 other. Cultures were negative. Cytology reveals rare atypical cells in a background of abundant mucoid material.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Maryam Kaous, Lara Bashoura, Saadia A. Faiz" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Maryam" "apellidos" => "Kaous" ] 1 => array:2 [ "nombre" => "Lara" "apellidos" => "Bashoura" ] 2 => array:2 [ "nombre" => "Saadia A." "apellidos" => "Faiz" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921002433?idApp=UINPBA00003Z" "url" => "/15792129/0000005700000008/v1_202108020523/S1579212921002433/v1_202108020523/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212921001865" "issn" => "15792129" "doi" => "10.1016/j.arbr.2021.05.014" "estado" => "S300" "fechaPublicacion" => "2021-08-01" "aid" => "2376" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2021;57:541" "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" => "Giant pulmonary artery aneurysm in pulmonary arterial hypertension" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "541" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aneurisma gigante de la arteria pulmonar en hipertensión arterial pulmonar" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1258 "Ancho" => 1675 "Tamanyo" => 278686 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A: chest X-ray, posteroanterior projection. B: transthoracic echocardiography, apical 4 chamber view. C: transthoracic echocardiography, short axis parasternal plane at the level of the large vessels. D–E: chest computed tomography with contrast medium, mediastinal window. F–G: coronary angiography, anteroposterior projection.</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">AP: pulmonary artery; VD: right ventricle; VI: left ventricle; AD: right atrium; AI: left atrium; Ao: Aorta; APD: right pulmonary artery.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pedro Caravaca Perez, Agueda Aurtenetxe Perez, Pilar Escribano Subias" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Pedro" "apellidos" => "Caravaca Perez" ] 1 => array:2 [ "nombre" => "Agueda" "apellidos" => "Aurtenetxe Perez" ] 2 => array:2 [ "nombre" => "Pilar" "apellidos" => "Escribano Subias" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S030028962030003X" "doi" => "10.1016/j.arbres.2019.12.020" "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/S030028962030003X?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921001865?idApp=UINPBA00003Z" "url" => "/15792129/0000005700000008/v1_202108020523/S1579212921001865/v1_202108020523/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Successful Surgical Treatment of a Giant Pulmonary Vein Ewing's Sarcoma Invading Left Atrium" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "542" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "F. Javier González-García, José Joaquín Domínguez del Castillo, Ángel Salvatierra Velázquez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "F. Javier" "apellidos" => "González-García" "email" => array:1 [ 0 => "fjaviergonzalez@outlook.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "José Joaquín" "apellidos" => "Domínguez del Castillo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Ángel" "apellidos" => "Salvatierra Velázquez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Thoracic Surgery and Lung Transplantation, University Hospital Reina Sofía, Córdoba, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Cardiovascular Surgery and Heart Transplantation, University Hospital Reina Sofía, Córdoba, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento quirúrgico exitoso de un sarcoma de Ewing gigante de la vena pulmonar que invade la aurícula izquierda" ] ] "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" => 433 "Ancho" => 950 "Tamanyo" => 81359 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) PET/CT image showing a hypermetabolic mass extending from the pulmonary vein (arrow) to the left atrium (asterisk). (B) Right lower lobectomy (arrow) with intra-atrial mass (arrow). (C) CT scan showing multiple parenchymal metastases.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 55-year-old woman underwent a routine pelvic magnetic resonance, identifying an inguinal lymph node highly suspicious of malignancy (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">A biopsy of the adenopathy suggested an Ewing sarcoma's metastasis. A body positron emission tomography (PET) only showed a hypermetabolic (Standardized Uptake Value of 13) mass located at the right inferior lobe (*) extending towards the left atrium (arrow) through the inferior pulmonary vein (A).</p><p id="par0015" class="elsevierStylePara elsevierViewall">The patient was submitted for radical surgery. Through an anterolateral thoracotomy and under cardiocirculatory bypass, with cardiac arrest, an en bloc right lower lobectomy with partial atrial resection and mass excision was performed (B). An autologous pericardial patch was used to reconstruct the left atrium.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The postoperative course was uneventful and the patient was discharged on the 6th postoperative day. Definitive histopathology findings were consistent with an Ewing's sarcoma from the inferior pulmonary extending towards the left atrium (arrow). Multiple parenchymal sarcoma foci were founded in the resected right inferior lobe, as expected in the preoperative CT scan. (circle) (C). Adjuvant Adriamycin-based treatment was performed.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Up to 20–30% of Ewing's sarcomas are extraoseal,<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a> appearing typically in older ages and females.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> International guidelines recommend a multidisciplinary treatment including radical surgery, radiation and chemotherapy.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "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" => 433 "Ancho" => 950 "Tamanyo" => 81359 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) PET/CT image showing a hypermetabolic mass extending from the pulmonary vein (arrow) to the left atrium (asterisk). (B) Right lower lobectomy (arrow) with intra-atrial mass (arrow). (C) CT scan showing multiple parenchymal metastases.</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" => "Extraeskeletal versus Skeletal Ewing Sarcoma in the adult population: controversies in care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.D. Lynch" 1 => "F. Gani" 2 => "C.F. Meyer" 3 => "C.D. Morris" 4 => "N. Ahuja" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Surg Oncol" "fecha" => "2018" "volumen" => "27" "paginaInicial" => "373" "paginaFinal" => "379" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A rare case of Ewing's sarcoma/primitive neuroectodermal tumor metastasizing to left atrium through left inferior pulmonary vein" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.K. Kulkarni" 1 => "N. Moorthy" 2 => "S. Somanna" 3 => "M.C. Nanjappa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/echo.13897" "Revista" => array:6 [ "tituloSerie" => "Echocardiography" "fecha" => "2018" "volumen" => "35" "paginaInicial" => "885" "paginaFinal" => "888" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29676474" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005700000008/v1_202108020523/S1579212921002378/v1_202108020523/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/15792129/0000005700000008/v1_202108020523/S1579212921002378/v1_202108020523/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921002378?idApp=UINPBA00003Z" ]
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