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Ramos Pascua, M. Antonia Rebollo Alvarado" "autores" => array:4 [ 0 => array:4 [ "nombre" => "José Ángel" "apellidos" => "Santos Sánchez" "email" => array:1 [ 0 => "jasalao@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" => "Almudena" "apellidos" => "Blázquez Sáez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Luís R." "apellidos" => "Ramos Pascua" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M. Antonia" "apellidos" => "Rebollo Alvarado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico, Hospital Universitario de Salamanca, Salamanca, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario de León, León, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lesiones líticas craneales" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 750 "Ancho" => 726 "Tamanyo" => 92996 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">56-year-old, asymptomatic woman visited A&E because of a fracture in her right femur, with no history of trauma. Radiological semiotics suggested pathological fracture, and a lytic lesion in the proximal diaphysis of the right fibula. The patient had a tumour in her frontoparietal region, which she attributed to a “lipoma” from a family inheritance. The study was completed with an anteroposterior (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) and lateral radiograph (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) of the skull, where multiple osteolytic images were visible in “punches”. The larger one (10<span class="elsevierStyleHsp" style=""></span>cm), which touched the diploe and both internal and external cranial tables, had a large soft tissue mass (*), visible in both projections, as the source of her frontal tumour. In addition, there was an expansive lytic lesion in the left clavicle (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> [arrow]). Laboratory studies detected serum calcium concentrations of 13.4<span class="elsevierStyleHsp" style=""></span>mg/dl (reference 8.6–10<span class="elsevierStyleHsp" style=""></span>mg/dl), haemoglobin 7.2<span class="elsevierStyleHsp" style=""></span>g/dl and creatinine of 1.58<span class="elsevierStyleHsp" style=""></span>mg/dl. Total protein in blood 5.5<span class="elsevierStyleHsp" style=""></span>g/dl (6.4–8.3<span class="elsevierStyleHsp" style=""></span>g<span class="elsevierStyleHsp" style=""></span>/dl). Index albumin/globulin 1.67 (1.3–2.2), immunoglobulin A, G, M and E in blood were below normal range. Total protein in urine at 24<span class="elsevierStyleHsp" style=""></span>h 1.22<span class="elsevierStyleHsp" style=""></span>g/24<span class="elsevierStyleHsp" style=""></span>h, beta 2-microglobulin 11<span class="elsevierStyleHsp" style=""></span>mg/dl (1.09–2.53<span class="elsevierStyleHsp" style=""></span>mg/dl), Bence Jones protein 0.38<span class="elsevierStyleHsp" style=""></span>g/24<span class="elsevierStyleHsp" style=""></span>h (0<span class="elsevierStyleHsp" style=""></span>g/24). Kappa light chains in the urine 89.6<span class="elsevierStyleHsp" style=""></span>mg/dl (0–0.85). The bone marrow biopsy sternal was slightly hypercellular, infiltrated by 37% plasma cells with red hypoplasia and megakaryocytic. A medullary blood flow cytometry showed a percentage of 4.70% plasma cells, and 100% of those were phenotypically pathological (CD138, CD38, CD 56 positive).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Santos Sánchez JÁ, Blázquez Sáez A, Ramos Pascua LR, Rebollo Alvarado MA. Lesiones líticas craneales. Med Clin (Barc). 2016;146:334.</p>" ] ] "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 750 "Ancho" => 540 "Tamanyo" => 57257 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 750 "Ancho" => 726 "Tamanyo" => 92996 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014600000007/v1_201607151011/S238702061630256X/v1_201607151011/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014600000007/v1_201607151011/S238702061630256X/v1_201607151011/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S238702061630256X?idApp=UINPBA00004N" ]
