Caso Clínico
A mass in the right atrium: A diagnostic dilemma
Masa en la aurícula derecha: un dilema diagnóstico
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Reporte de un caso" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "314" "paginaFinal" => "316" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cardiac hibernoma in the right atrium and around superior cava vein. A case report" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1407 "Ancho" => 1500 "Tamanyo" => 149364 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Imagen del FDG-PET/TC que muestra una masa en la AD y alrededor de la VCS con un metabolismo aumentado (flecha).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rebeca Mata-Caballero, Jesús Saavedra-Falero, Javier López-Pais, Luis Molina-Blázquez, María T. 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"apellidos" => "Alberca-Vela" ] 5 => array:2 [ "nombre" => "Alberto" "apellidos" => "Forteza-Gil" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134009616301942?idApp=UINPBA00004N" "url" => "/11340096/0000002400000005/v1_201709120058/S1134009616301942/v1_201709120058/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1134009617300013" "issn" => "11340096" "doi" => "10.1016/j.circv.2016.12.001" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "325" "copyright" => "Sociedad Española de Cirugía Torácica-Cardiovascular" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Cir Cardiov. 2017;24:309-10" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2007 "formatos" => array:3 [ "EPUB" => 60 "HTML" => 1598 "PDF" => 349 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Caso Clínico</span>" "titulo" => "Trombectomía de vena cava inferior y aurícula derecha secundaria a carcinoma renal" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "309" "paginaFinal" => "310" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Vena cava and right atrium thrombectomy secondary to carcinoma renal cell" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figura 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1424 "Ancho" => 1650 "Tamanyo" => 268350 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Imagen ilustrativa de la técnica de la cuchara que realizamos en nuestro centro para la extracción del trombo a nivel de la aurícula derecha. Se utiliza una cuchara como instrumental en la cirugía y se reseca la masa infiltrante en su totalidad sin incidencias.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Azahara Fernández Carbonell, M. Teresa Conejero Jurado, Juan José Salamanca Bustos, Ignacio Muñoz Carvajal" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Azahara" "apellidos" => "Fernández Carbonell" ] 1 => array:2 [ "nombre" => "M. Teresa" "apellidos" => "Conejero Jurado" ] 2 => array:2 [ "nombre" => "Juan José" "apellidos" => "Salamanca Bustos" ] 3 => array:2 [ "nombre" => "Ignacio" "apellidos" => "Muñoz Carvajal" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134009617300013?idApp=UINPBA00004N" "url" => "/11340096/0000002400000005/v1_201709120058/S1134009617300013/v1_201709120058/es/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Caso Clínico</span>" "titulo" => "A mass in the right atrium: A diagnostic dilemma" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "311" "paginaFinal" => "313" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Santiago Colunga Blanco, María Martín Fernández, Cecilia Corros Vicente, Rubén Álvarez Cabo, M. Aurora Astudillo González" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Santiago" "apellidos" => "Colunga Blanco" "email" => array:1 [ 0 => "santicolunga@hotmail.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" => "María" "apellidos" => "Martín Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Cecilia" "apellidos" => "Corros Vicente" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Rubén" "apellidos" => "Álvarez Cabo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "M. Aurora" "apellidos" => "Astudillo González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Cirugía Cardiaca, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Anatomía Patológica, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Masa en la aurícula derecha: un dilema diagnóstico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1876 "Ancho" => 2500 "Tamanyo" => 526346 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Histopathological study confirmed diagnosis of mixoma.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 68-year old woman with previous aortic valve replacement with a mechanical prosthesis three years ago was admitted to our hospital with a recent onset atrial fibrillation. Transthoracic echocardiography was performed. It described a well-circumscribed polypoid mass in the right atrium which seemed to be attached to the septal leaflet of the tricuspid valve (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B). Subsequently a transesophageal echocardiography confirmed this finding (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C and D: 17<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>12<span class="elsevierStyleHsp" style=""></span>mm ovoid mass without obstructing tricuspid valve). Otherwise, right cavities were normal and prosthesis had also a normal function.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">In the absence of clinical signs of endocarditis, suspected diagnosis of tumor was established.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1,4</span></a> Cardiac MRI for a better characterization was performed. It confirmed a well-defined mobile mass in the right atrium attached to the septal leaflet of the tricuspid, hypointense in gradient echo sequences and with early and late heterogeneous gadolinium hyperenhancement (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A–D). Once the study was completed the most likely diagnosis of myxoma was established.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1–3</span></a></p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Surgical resection was performed. Intraoperative biopsy was compatible with myxoma and histopathological study confirmed the diagnosis (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a> A and B)</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Intracardiac primary tumors are rare and highly variable in their clinical expression. It can range from incidental diagnosis, as in our case, to sudden death. Although myxomas are the most frequent primary tumors, right atrial is an atipical location leading to a diagnostic dilemma.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">2–4</span></a> Differential diagnosis with malignant tumors, metastasis, vegetations and even with normal variants must be taken into account.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Protection of human and animal subjects</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Confidentiality of data</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article.</p></span></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:6 [ 0 => array:3 [ "identificador" => "xres899620" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec880705" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres899621" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec880704" "titulo" => "Palabras clave" ] 4 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 5 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec880705" "palabras" => array:5 [ 0 => "Myxoma" 1 => "Right atrium" 2 => "Echocardiography" 3 => "Tumors" 4 => "Cardiac MRI" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec880704" "palabras" => array:5 [ 0 => "Mixoma" 1 => "Aurícula derecha" 2 => "Ecocardiografía" 3 => "Tumores" 4 => "Resonancia magnética cardiaca" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">In this article we highlight the importance of cardiac imaging techniques and proper differential diagnosis to tackling the evaluation of cardiac masses in the right chambers.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">En este artículo queremos resaltar la importancia de las técnicas de imagen cardiaca en el adecuado diagnóstico diferencial a la hora de abordar el estudio de las masas cardiacas en las cavidades derechas.</p></span>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1999 "Ancho" => 2667 "Tamanyo" => 359382 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) and (B) TTE polypoid mass in the right atrium attached to the septal leaflet of the tricuspid valve. (C) and (D) Transesophageal echocardiography confirmed de previous findings.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2344 "Ancho" => 2667 "Tamanyo" => 314047 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">(A) and (B) Gradient echo sequences. A mass in the right atrium attached to the septal leaflet of the tricuspid, hypointense. (C) and (D) Enhancement sequences. Early and late heterogeneous gadolinium hyperenhancement.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1876 "Ancho" => 2500 "Tamanyo" => 526346 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Histopathological study confirmed diagnosis of mixoma.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The differentiation of giant right atrial myxoma from metastatic cancer with the use of multiple imaging modalities" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. 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Berman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/10976640600777975" "Revista" => array:6 [ "tituloSerie" => "J Cardiovasc Magn Reson" "fecha" => "2006" "volumen" => "8" "paginaInicial" => "839" "paginaFinal" => "853" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17060107" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0040" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mixoma gigante de aurícula derecha. Presentación de un caso" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Muñoz Serret" 1 => "E. García" 2 => "J. Páez" 3 => "E. Hernández" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Cir Cardiovasc" "fecha" => "2013" "volumen" => "20" "paginaInicial" => "203" "paginaFinal" => "205" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/11340096/0000002400000005/v1_201709120058/S1134009616302571/v1_201709120058/en/main.assets" "Apartado" => array:4 [ "identificador" => "37281" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Casos Clínicos" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/11340096/0000002400000005/v1_201709120058/S1134009616302571/v1_201709120058/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134009616302571?idApp=UINPBA00004N" ]
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| 2020 January | 21 | 7 | 28 |
| 2019 December | 19 | 6 | 25 |
| 2019 November | 11 | 5 | 16 |
| 2019 October | 19 | 8 | 27 |
| 2019 September | 27 | 8 | 35 |
| 2019 August | 10 | 1 | 11 |
| 2019 July | 15 | 3 | 18 |
| 2019 June | 34 | 19 | 53 |
| 2019 May | 108 | 49 | 157 |
| 2019 April | 29 | 3 | 32 |
| 2019 March | 10 | 4 | 14 |
| 2019 February | 14 | 4 | 18 |
| 2019 January | 4 | 4 | 8 |
| 2018 December | 6 | 4 | 10 |
| 2018 November | 5 | 4 | 9 |
| 2018 October | 12 | 5 | 17 |
| 2018 September | 5 | 2 | 7 |
| 2018 August | 6 | 2 | 8 |
| 2018 July | 6 | 2 | 8 |
| 2018 June | 4 | 1 | 5 |
| 2018 May | 1 | 3 | 4 |
| 2018 April | 7 | 1 | 8 |
| 2018 March | 5 | 1 | 6 |
| 2018 February | 12 | 1 | 13 |
| 2018 January | 4 | 0 | 4 |
| 2017 December | 17 | 2 | 19 |
| 2017 November | 25 | 11 | 36 |
| 2017 October | 37 | 7 | 44 |
| 2017 September | 22 | 12 | 34 |
| 2017 August | 1 | 4 | 5 |
| 2017 July | 2 | 9 | 11 |
| 2017 June | 8 | 8 | 16 |
| 2017 May | 10 | 11 | 21 |
| 2017 April | 7 | 32 | 39 |
| 2017 March | 14 | 42 | 56 |
| 2017 February | 4 | 12 | 16 |
Show all
